Tertiary Care Teaching Hospital Research Articles

Initial experience of robotic-assisted cholecystectomy in a tertiary care teaching hospital

Abstract Background: Robotic surgery was designed to overcome some of the major limitations of laparoscopy in terms of visibility, dexterity and precision. However, its potential limitations include high costs and low tactile feedback. at a tertiary care teaching hospital. Methods: In this retrospective study, we assessed the safety and feasibility of robotic-assisted cholecystectomy using the Versius Surgical Robot System® at our tertiary care teaching hospital between 2 September 2021 and 22 August 2022. Results: Of the 30 patients studied, 11 were males. The mean body mass index of the patients was 25.7. Intraoperative complications were noted in one case (haemorrhage from the liver bed) and conversion to laparoscopic surgery was noted in the same case. The median docking time was 16 min and the median console time was 72 min. No post-operative complications were noted. Both docking time and console time significantly decreased throughout this study. Conclusions: This study shows that the robotic-assisted cholecystectomy is a promising, safe and feasible alternative to traditional laparoscopic cholecystectomy.

Knowledge, attitude and perception on organ donation amongst undergraduate students, post-graduate students and senior residents at a tertiary care teaching hospital in North-eastern India: A cross-sectional study

Abstract Background: Organ transplantation is one of the most important modalities of treatment for patients with end-stage renal diseases. The involvement of healthcare professionals is one of the key factors in increasing awareness about organ donation and transplantation. Methods: A cross-sectional descriptive questionnaire-based study was conducted amongst undergraduate, post-graduate junior residents and senior resident doctors (n = 113) in a tertiary care teaching hospital using convenient sampling. We studied the knowledge, attitude and perception on organ donation Results: We observed that 94.6% of the participants had a positive attitude towards organ donation and around 83% were willing to donate their organs. However, the participants lacked adequate knowledge about the process of organ donation and the various aspects related to it. Conclusions: The medical students and young doctors had a positive attitude towards organ donation, and most of the study participants are willing to donate. However, knowledge regarding it lacked in majority of the students.

Antimicrobial agent usage patterns and their role in preventing surgical site infections at a tertiary care teaching hospital: A comprehensive study

Background: Surgical site infections (SSIs) present a formidable challenge in contemporary healthcare, impacting patient well-being and contributing to escalating healthcare costs. The judicious utilization of antimicrobial agents is paramount in effectively combating SSIs. This study, conducted at a Tertiary Care Teaching Hospital in Kerala, seeks to unravel the intricate patterns of antimicrobial agent usage within the General Surgery Department over 10 months. Aims and Objectives: The primary aim is to thoroughly examine antimicrobial agent patterns within the General Surgery Department, focusing specifically on patients undergoing surgical procedures. The study aims to assess the appropriateness of antimicrobial agent usage, encompassing the choice for prophylactic purposes, timing of pre-operative dosing, the occurrence of intraoperative dosing, and the selection appropriateness for post-operative prophylaxis. Materials and Methods: Crafted for robust analysis, the study included 150 cases, implementing specific inclusion and exclusion criteria to ensure data quality. The emphasis was placed on patients undergoing surgical procedures, focusing on prophylactic antimicrobial use. Data collection involved meticulously evaluating appropriateness across critical parameters, including the choice of prophylactic antimicrobial agent, pre-operative dosing timing, intraoperative dosing, and selection appropriateness for post-operative prophylaxis. Results: Analysis of 150 cases provided valuable insights into the age and gender distribution, predominantly within the 41–60 age groups. Prevalent surgical procedures, such as hernia and appendicitis, underscored the necessity for tailored antimicrobial protocols. Cephalosporins emerged as the dominant class, raising concerns about potential overuse and resistance. Pre-exposure prophylactic antibiotics, predominantly cephalosporins, were administered in 88 cases. Post-exposure prophylaxis mirrored this trend, necessitating a critical evaluation of antibiotic selection and duration. Detailed analysis of cephalosporin pre- and post-exposure prophylaxis identified prevalent choices such as Cefotaxime and Cefoperazone + Sulbactam, emphasizing the importance of scrutinizing cephalosporin selection. Conclusion: This study furnishes valuable insights into the appropriateness of antimicrobial agent usage for preventing SSIs, serving as a model for analogous healthcare settings. It underscores the significance of local antibiotic stewardship, guideline adherence, and the ongoing commitment to optimizing prophylactic antimicrobial usage for ensuring patient safety and advancing healthcare quality amidst evolving challenges.

Turnaround Time of Patients in Emergency Department at a Tertiary Care Teaching Hospital in Uttarakhand, India: A Cross-sectional Study

Introduction: The Emergency Department (ED) is the point of first contact for any critically ill patient needing immediate medical attention. EDs use a triage system which ensures people who are critically ill are treated first. Turnaround Time (TAT) for the ED is taken as the time from the patient’s arrival in the ED to either their hospitalisation or discharge. Aim: To estimate the TAT of patients in the ED at a tertiary care teaching hospital. Materials and Methods: This cross-sectional study was conducted from August 1 to August 31, 2022, at the ED of Himalayan Hospital, Dehradun, Uttarakhand, India. A sample size of 300 patients were selected using a simple random sampling technique. Data were collected by direct observation using a data collection sheet. Timings were recorded with the help of a stopwatch. Statistical analysis was performed using the data analysis tool in Microsoft Excel and Statistical Package for Social Sciences (SPSS) version 23.0. Pearson coefficient of correlation (r-value) and p-value were calculated. The level of statistical significance was set at 5% (p-value <0.05). Results: Most of the patients attending the ED were over 60 years of age 65 (21.7%). Only 24 (8%) patients were triaged as priority 1 (Red), whereas priority 2 (Yellow) and priority 3 (Green) patients were 135 (45%) and 141 (47%), respectively. It was observed that a maximum of 79 (26%) patients reported to the ED between 4 pm to 8 pm. A total of 186 (63%) patients were given final disposal within three hours of their arrival in the ED. The overall average length of stay in the ED was 2 hours, 53 minutes, and 4 seconds, or 173 minutes. Conclusion: The study provided valuable insight into the causes of the increased TAT of patients in the ED. The highest time (1 hour, 48 minutes, and 59 seconds±1 hour, 31 minutes, and 43 seconds, constituting 63% of the total time in the ED) was taken by radiological investigations in the ED, followed by the time of 36 minutes and 30 seconds±39 minutes and 3 seconds (21% of total time in the emergency) for shifting patients.

A Prospective Observational Study on Drug Utilization in Renal Impaired Patients at Tertiary Care Teaching Hospital

Abstract Introduction: Renal impairment is characterized by a progressive decline in glomerular filtration rate, a significant public health issue worldwide associated with high morbidity and mortality. In most cases, renal impairment is associated with comorbidities such as hypertension and diabetes, which require multiple drug therapy during a course of treatment, leading to polypharmacy. Objective: The objective of this study was to assess the prescribing pattern of drugs in renal-impaired patients at Dhiraj General Hospital. Materials and Methods: A total of 150 patients with renal impairment were finally recruited after strictly obeying the selection criteria in this cross-sectional, observational study conducted over 6 months in a tertiary care teaching hospital, directorate general of hydrocarbons. Relevant data were extracted by interviewing the patients and from prescriptions, case records, and investigational reports. Results: Of the total 150 patients, 94 (63%) were male and 56 (37%) female. The highest numbers of patients were in the age group >60 years (59 patients, 39.3%). Anemia was the most common comorbidity (143 patients, 95%) observed, followed by hypertension (129 patients, 86%) and diabetes mellitus (64 patients, 43%). A total of 1693 drugs were prescribed to 150 renal-impaired patients. Each patient received an average of 11.19 ± 3.51 (8%) drugs. Polypharmacy was seen in all patients. Drugs acting on the cardiovascular system constituted the bulk of the prescriptions (25.87%), followed by gastrointestinal (GI) drugs (18.72%), vitamins and minerals (14.94%), and antibiotics (8.33%). Conclusion: There is polypharmacy in patients with renal impairment due to associated comorbidities. The prevalence of polypharmacy was high in patients with chronic kidney disease (CKD). Antihypertensive drugs, drugs used for the GI system, antibiotics, and antidiabetic drugs were frequently used in CKD patients.

Spontaneously reported adverse drug reaction pattern in a tertiary care teaching hospital: A cross-sectional study

Background: Adverse drug reactions (ADRs) are unintended and harmful reactions to medications that occur at doses normally used for therapeutic purposes. The reporting of ADRs is essential for the identification and prevention of ADRs. Aims and Objectives: The aim of the study was to estimate the frequency and distribution of spontaneously reported ADRs in the tertiary care teaching hospital. Materials and Methods: A retrospective cross-sectional study was conducted from July 2020 to June 2023, from spontaneously reported ADRs by the ADR Monitoring Centre, MGM Medical College, Kishanganj, Bihar. Distribution of age, gender, department, medication groups, and systems involved were examined. Utilizing certain scales, causality, severity, and preventability were evaluated. Results: Total 47 ADRs were reported during the study period. The most common ADRs were cutaneous ADRs (n = 19,40.43%) followed by the central nervous system (CNS) (n = 12, 25.53%), gastrointestinal system (GI) (n = 9, 19.15%), musculoskeletal (n = 4, 8.51%) and others. The most commonly implicated drugs were Antibiotics (21.28%) followed by analgesics (12.77%), DMARD (12.77%), antihypertensive (12.77%), and others shown in the study. The severity assessment of ADRs was done by Modified Hartwig et al. severity assessment scale and was found mild (87%), followed by moderate (8.5%) and severe (4.3%). Using the modified Schumock and Thronton preventability scale preventability assessment of ADRs was done and was found 51.06% of ADRs were definitely preventable, 38.30% were probably preventable and 12.77% of ADRs were not preventable. Conclusion: The findings of this study emphasize the significance of pharmacovigilance and the requirement that medical personnel be knowledgeable about the indications and symptoms of ADRs.

The demographic profile, clinical spectrum, and outcome of term neonates requiring continuous positive airway pressure in a tertiary care teaching hospital

Background: Respiratory distress is the major cause of neonatal intensive care unit (NICU) admission of full-term neonates for which they require different levels of mode of ventilation. Aims and Objectives: The objective of this study was to determine the demographic profile, clinical spectrum, and outcome of term neonates, requiring continuous positive airway pressure (CPAP) in tertiary care teaching hospitals. Materials and Methods: The study was a prospective observational study conducted from December 2020 to November 2022 in the neonatal section of the department of pediatrics. Results: A total of 261 neonates were included in the study. The male-to-female ratio was 1.7:1, the range of birth weight was between 2.1 kg and 3 kg (60.91%), the gestation age was 38 weeks (59.2%), and 73.6% were lower-segment cesarean section born. The age of starting CPAP in most of the newborns was at admission to NICU (in 69.73% of cases). The success rate of CPAP therapy was high (60.9%) and the rest 39.08% of patients did not settle with CPAP and required higher modes of respiratory support such as nasalintermittent positive pressure ventilation (IPPV) (5.89%) and IPPV (94.11%). Conclusion: In the resource-limiting settings, due to the non-availability of higher levels of ventilatory gadgets, the early use of CPAP as a mode of ventilation in full-term babies with transient tachypnea of newborns is well-documented and it can be safely used in other common neonatal conditions which can cause respiratory distress in full-term neonates. The low-middle-income countries are facing challenges to improve comprehensive neonatal care; there is a dire need for simple and cost-effective methods of respiratory support. Bubble CPAP is one such promising ventilatory support intervention, which may reduce the need for costly mechanical ventilators.

Drug utilization study of pre-anesthetic, intraoperative, and post-operative medications use in various surgeries of orthopedic and surgery department of tertiary care teaching hospital

Background: Every year millions of patients undergo surgery. The prescribing pattern of medications in patients undergoing surgery may differ based on the hospital setup, profile of the patient, and type of surgical procedure. Hence, the present study is undertaken to know the prescribing pattern of pre-anesthetic, intraoperative, and post-operative agents in surgery and orthopedic department. Aims and Objectives: The aim of this study was to analyze the pattern of pre-anesthetic, intraoperative and post-operative medications used in surgery and orthopedic departments at a tertiary care teaching hospital. Materials and Methods: This cross-sectional, observational study was conducted in the departments of surgery and orthopedic in a tertiary care teaching hospital after taking approval from Institutional Ethics Committee. The details of demographic, clinical data and drugs prescribed during the pre-operative, intraoperative, and post-operative period were recorded in a preformed case record form and analyzed using descriptive statistics. Results: A total of 400 patients prescriptions were collected and analyzed which included 244 patients in orthopedic department and 156 patients in the surgery department. The average number of drugs per encounter was 10.01 and 7.25 in the surgery and orthopedic department, respectively. Preoperatively, the majority of patients received ondansetron (99.5%) followed by glycopyrrolate, midazolam, tramadol, and ranitidine. Surgery was done either under general anesthesia (sodium thiopental and sevoflurane) or local anesthesia (Bupivacaine). Skeletal muscle relaxants used along with general anesthetics included succinylcholine, atracurium, and vecuronium. Postoperatively, antimicrobial agents (AMAs) (831) were most commonly used followed by analgesic agents (368). The majority of AMAs were used from “Watch group” (50%) compared to “Access group” (38.88%) (World Health Organization-Access, Watch, Reserve classification). Conclusion: The present study gives an insight into the use of pre-anesthetic, intraoperative, and post-operative medications in our set-up. Generic medicines are used more which is good as it reduces the cost. Post-operative antimicrobial usage was more from the “Watch group” compared to the “Access group,” which is a concern and needs implementation of antibiotic policy.

Emerging trends of antimicrobial sensitivity and resistance pattern and drug utilization study in burn patients at tertiary care teaching hospital

Background: One of the cases of accidental injuries is burns. Globally, every year estimated 180,000 mortalities occur due to burns, and most of the deaths are seen in the lower or poor socioeconomic class of developing countries. Due to predominantly poor and low socioeconomic status, overpopulation, poor education, and unreachability to advanced burn care in certain parts of the country - the incidence, complications, and deaths have continued to rise in developing countries. About 75% of the deaths associated with burn injuries are related to wound infection, especially in developing countries. The present study was undertaken to study the microflora of burn wounds as well as drug utilization in the management of burn patients in a tertiary care teaching hospital. Aims and objectives: Assessment of antimicrobial susceptibility and resistant pattern and drug utilization in burns patients. Materials and Methods: This observational cross-sectional descriptive study was performed on 130 hospitalized burn patients over 12 months (from November 2020 to November 2021). All burn patients who were admitted in the hospital and received at least 1 day of treatment were included in the study. All required information, including demographic data, prescribed medication, microbial culture sensitivity report, and treatment outcome were recorded in the case record form. Descriptive statistics using Microsoft Excel version 2019. Results: Of a total of 130 burn patients, 52% were females. The most common type of burn was flame in 69% of patients. The mean length of hospital stay was 9 days and it ranged from 1 to 40 days. Culture from burns wound revealed Pseudomonas aeruginosa (47.6%) as the most common organism isolated followed by Klebsiella pneumoniae (45.2%), Acinetobacter baumannii (14.2%), Proteus mirabilis (14.2%), Staphylococcus aureus (9.5%), and Escherichia coli (4.7%). Among the isolated microorganisms, most of them showed sensitivity to beta-lactam, aminoglycoside, and tetracyclines. Sulphonamide was dominant among the topically applied antibiotics, whereas cephalosporins were dominant among the systemically administered antibiotics. The average number of drugs pre-prescription ranges from 6.5 to 8.5. Conclusion: The present study results are helpful in understanding the pattern of burns wound sepsis, the dominant bacterial organism, the antimicrobial susceptibility/resistance, and the drug utilization pattern in burn patients.

Potential Drug-Drug Interactions among Geriatric Patients in Medicine Department at a Tertiary Care Teaching Hospital - A Prospective Observational Study

Background Drug-drug interactions occur when therapeutic effect of one drug is altered by another drug during co-administration. These effects may result in increase or decrease in the action of either of the substances or it may cause adverse effect that is abnormally associated with either of the drugs. Data was collected from patients admitted in the Emergency Department.Aim The objective of the study was to identify evaluate and analyze the drug-drug interactions found in the prescriptions of elderly patients visiting the Medical department at a tertiary care teaching hospital.Methods This prospective observational study was undertaken in an Emergency ward for a period of six months to identify evaluate and analyze the drug-drug interactions. Ethical clearance was obtained from the Institutional Ethical Committee of SCS College of Pharmacy Harapanahalli. A total of three hundred and fifty cases were reviewed and details such as demographics past medical and medication history prescribed drugs and drug interactions were recorded.Results The data of 350 patients was included in the study. In our study a total of 405 drug-drug interactions were seen in 191 patients. The most commonly involved drugs were hydrocortisone and furosemide. Increased polypharmacy was observed in patients with co-morbid conditions leading to increased risk of potential drug-drug interactions PDDI.Conclusion Our study revealed that geriatric patients have higher risk for polypharmacy due to the presence of co-morbid conditions. Overall the incidence of PDDI was high and most interactions were pharmacodynamic in nature.nbsp

COVID-19 pandemic period - adverse drug reactions reporting, observing, assessing and analysis at tertiary care teaching hospital, IMS-BHU Varanasi – 3-years observational study

Background: Effects of drugs that are undesirable and beyond their therapeutic effect are labeled as adverse drug reactions (ADRs). These often lead to increase hospital stay, repeated hospitalization, adversely affecting the quality of life, and perhaps, one of the causes of mortality making it a chief challenge in modern health-care system. This observational study analyzed and summarized details linked to ADRs identification, reporting, severity, treatment, and preventive measures for health professionals. Aims and Objectives: The objectives of the study are to assess and evaluate demographic profile, drug prescribed with its dosage, clinical findings, seriousness, outcome, causality, and organ system affected by concerned ADRs. Materials and Methods: An observational prospective study analyzing submitted ADRs mentioned in individual case safety reports (ICSR), mentioning demographics profile, suspected drug, involved bodily organ system, causality and reaction severity in different age groups of indoor and outdoor patients reported from 2020 January to 2022 December at ADR monitoring center, Department of Pharmacology, IMS-BHU. Performa used for ADRs reporting is ICSR, which later on transferred to the Indian database (VigiFlow) for data collection and analysis. Results: Total 1096 ADRs were identified and reported in 36-month duration, with male (629/1096) to female (466/1096) ratio of 1.35:1. On age group analysis, 74.8% (820/1096) adults (18–59 years) followed by 23.4% (256/1096) elderly (>59 years) and only 1.8% (20/1096) children and adolescents (<17 years) cases were found. Endocrine system was the most common organ system affected with 27.9% case (306/1096), succeeded by 25.4% (278/1096). ADRs were linked to the gastrointestinal system and 15.69% (172/1096) cases were related to dermatological problems. Antimicrobial drugs were most involved group, which on further analyzing and classifying revealed majority of ADRs were related to antiviral drugs, followed by antibiotics with 27.2% (298/1096) and 23.4% (257/1096) cases, respectively. Antiallergic and antifungal drug groups were found be least involved with only 1.6% (17/1096) cases each. On assessment of causality, majority of ADRs were possible in 60.40% (662/1096) cases and probable in 39.14% (429/1096) cases. Conclusion: Occurrence of ADRs is very common and perhaps a serious concern regarding well-being and safety of public as may lead to non-serious to serious health problems. This observational study identified the need of increased awareness of ADR monitoring, reporting and benefits, to fulfill the space created by under-reporting, especially in geriatrics and pediatric age group patients. A detail evaluation and removal of the barriers so that all the patients may easily approach for spontaneous reporting of side effects after start usage of any medicinal product, if any. In addition, surveillance studies emphasizing on reporting are essential for early recognition, detection, and avoidance of ADRs leading to appropriate with safe usage of drugs.

Antimicrobial Use and Adverse Drug Reaction in Newborns with Neonatal Sepsis: A Prospective Observational Study from a Tertiary Care Teaching Hospital

Introduction: Neonatal Sepsis (NS) is a major cause of morbidity and mortality worldwide, especially in developing countries like India. The role of antimicrobials is life-saving in NS. To achieve a good prognosis, early diagnosis and appropriate treatment are required. Data related to the irrational use of antimicrobials in neonates are limited. Aim: To evaluate the drug usage pattern and Adverse Drug Reactions (ADRs) of antimicrobials in NS. Materials and Methods: A prospective observational study was conducted among 350 neonates who were admitted and diagnosed with NS from January to December 2021 in the Neonatal Intensive Care Unit (NICU) of PDU Medical College and Civil Hospital, Rajkot, Gujarat, India. Demographic data such as age, sex, birth weight, and clinical data such as type of delivery, type of sepsis, culture-sensitivity status, and antimicrobials used were recorded. Suspected ADRs were reported in the pharmacovigilance database. Categorical data were analysed in percentage, whereas some clinical data were analysed with mean and median using Microsoft Office Excel-2019. Results: In the present study, 172 (49.15%) male and 178 (50.85%) female neonates were almost equally affected. The mean gestational age and birth weight were 35 ± 3.6 weeks and 2 ± 0.7 kg, respectively. Early-Onset Neonatal Sepsis (EONS) cases were more at 273 (78%) compared to Late-Onset Neonatal Sepsis (LONS). Seventeen different antimicrobials were used. The average number of antimicrobials used per case was 2.9. The Piperacillin Tazobactam was the most commonly used antimicrobial in 173 cases (49.43%) in early-onset sepsis, while Meropenem was used in 40 cases (11.43%) in late-onset sepsis. Coagulase-negative Staphylococcus was the most commonly isolated organism in 15 cases (4.2%), followed by Klebsiella Pneumoniae in 13 cases (3.7%). Twelve out of 17 antimicrobials (70.59%) were not included in the first list of essential medicines for children of India in 2011. Six ADRs were reported in the present study. Conclusion: In all admitted cases of sepsis, empirical therapy was given, but variations from standard recommendations were observed in dose and frequency. A periodic survey of antimicrobial use patterns in NS will be useful in the rational selection of empirical therapy.

Predictive Value of Perfusion Index for Assessing Success of Supraclavicular Brachial Plexus Block: A Prospective Observational Study

Abstract Background: Perfusion index (PI) is a simple, objective, and noninvasive method for evaluating the success of brachial plexus blocks. There is only one study which assessed the time point at which the PI had the best predictive value. Aims: Of the 5 measured outcome variables (i.e.; PI at baseline, at 5 min, at 10 min, and at 15 min and PI ratio), we wanted to determine the one which had the best predictive value for block success. Materials and Methods: It is a prospective observational study done in a tertiary care teaching hospital. Sixty-nine patients of either sex, American Society of Anesthesiologists Physical Status I and II, between the ages of 18 and 65 years posted for elective upper limb surgery were included. Patients were given supraclavicular blocks with a peripheral nerve stimulator. PI recorded at baseline, 5 min, 10 min, and 15 min. A PI ratio was calculated. Sensory and motor blocks were assessed at 5-min intervals. Statistical Analysis: Descriptive analysis was applied by mean and standard deviation for quantitative variables and frequency and proportion for categorical variables. Receiver operating characteristic (ROC) curves were constructed. SPSS version 22 was used to detect an area under the ROCs (AUROC) curve and calculated to assess how good a test PI at 10 and 15 min and PI ratio are in predicting the outcome of a block. Results: The mean PI increased continuously from the baseline till 15 min in successful blocks, but in unsuccessful blocks, the rise was not seen. ROC curves showed an AUROC curve of 0.93 in case of PI at 15 min and 0.84 for PI ratio. Conclusion: We conclude that PI at 15 min is the best in our study and PI ratio is the next best as a predictor for evaluating success of supraclavicular blocks.

Histopathological study of vesiculobullous lesions of skin in a tertiary care teaching hospital

Histopathological study of vesiculobullous lesions of skin in a tertiary care teaching hospital

Assessment of Smartphone Medical Applications as a Self-Directed Learning Tool for Medical Students and Compulsory Rotatory Residential Internship-A KAP Survey.

Smartphones have become a powerful instrument in academic life for medical professions worldwide. Global lockdown due to COVID-19 pandemic culminated in the closure of educational institutions and resulted in shifting to online teaching. In our newly implemented competency-based medical education curriculum (CBME) for medical graduates, self-directed learning (SDL) is one of the teachings-learning methods. Smartphones are an essential tool for SDL in medical school. This main objective of the study is to determine the usage of health apps in a tertiary care teaching hospital to encourage the medical students and compulsory rotatory residential internship (CRRI) to continue SDL process. This cross-sectional questionnaire-based study was conducted for the period of 30 days for medical students and CRRI's at a tertiary care teaching hospital. The population was selected using convenient sampling method. This anonymous questionnaire was validated by the experts and the questions encompassing knowledge, attitude and perception (KAP Survey) of the students toward smartphone medical apps was utilized for this survey. Out of 582 participants, only 250 students (43%) have participated in the survey. Our study shows that 95% of students were handling android smartphones, and 84% of them were using various medical applications on them and it leads to SDL. The impact of the lockdown has increased SDL. Majority of the students (51.8-69.8%) have agreed that medical apps enhanced their SDL and helped them to study independently.

Insight into Stenotrophomonas maltophilia Infections in a Tertiary Care Teaching Hospital in Western India and Review of Literature: A Retrospective Observational Study

Introduction: Stenotrophomonas maltophilia (S. maltophilia) is a ubiquitous and opportunistic pathogen of growing importance. This gram-negative, non fermenter is widely distributed in moist hospital environments. It is intrinsically resistant to a number of antibiotics, making it a challenge both for the clinician and the microbiologist. Very sparse data is available from Western India regarding this emerging pathogen. Aim: To determine the prevalence and spectrum of infections caused by S. maltophilia and to provide an overview of associated co-morbidities, antibiotic susceptibility pattern of these isolates, and clinical outcomes. Materials and Methods: This retrospective observational study was carried out in a tertiary care private hospital (Mahatma Gandhi Hospital) in Jaipur, Rajasthan, India over a period of one year (July 2021-June 2022). A total of 11,170 samples were received in the microbiology laboratory for bacterial culture and susceptibility testing during the study period and processed as per standard protocols. Only one isolate per patient was included for the purpose of the study. Culture identification and antibiotic susceptibility testing was done using the VITEK-2 automated system. Data regarding patients’ demographic profile, epidemiological profile, baseline characteristics, comorbidities, laboratory findings, and clinical outcome were tabulated in an Excel worksheet and analysed. All statistical analysis was done using the Software Statistical Package for the Social Sciences (SPSS) version 20.0. Results: Fourteen patients were found to have S. maltophilia infection during the study period. The majority of patients had respiratory tract infection and bacteraemia. All isolates were from inpatients, more than two-thirds being from the Intensive Care Unit (ICU). A high level of susceptibility was seen to routinely recommended drugs, with 100%, 93% and 79% being susceptible to minocycline, levofloxacin and co-trimoxazole, respectively. All patients (except one) were successfully managed and discharged. Conclusion: S. maltophilia is an emerging opportunistic pathogen and is associated with a plethora of clinical conditions. Early and accurate diagnosis by embracing automation in microbiology laboratories is essential to identify this pathogen. S. maltophilia infections have a favourable outcome when diagnosed and treated timely

A Comparative Study on the General and Otolaryngological Manifestations of COVID-19 in the Hospitalized Population of the Telangana Region During the First and Second Waves.

Introduction Some common symptoms of coronavirus disease 2019 (COVID-19) are fever, cough, and shortness of breath. But ear, nose, and throat (ENT) manifestations such as loss of smell and taste are also very common. Objectives To compare the general and otorhinolaryngological manifestations of COVID-19 and to compare the treatments given and mortality rate during its two waves. Methods This retrospective study was conducted on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in a tertiary care teaching hospital. Six hundred patients were included in the 1st wave sample and 516 were in the 2nd wave sample. The data collected included demographics, comorbidities, general, and ENT symptoms, need for ventilatory support, oxygen therapy, and mortality for both the waves. Results Fever, malaise, and myalgia were more frequently presented in the first wave than in the second, whereas shortness of breath was more common in the second wave. In the second wave, a significant increase in anosmia cases was reported, whereas sore throat, nasal obstruction, dysphagia, nasal discharge, and sneezing were significantly reduced compared with the first wave ( p < 0.001). The case fatality rate increased from 11.33 to 21.55% ( p < 0.001) from the 1 st to the 2 nd wave. The patients who died in the second wave were younger than those in the first wave. Two doses of vaccination showed protection from the death over those not vaccinated and those who only received one dose ( p < 0.05). Conclusion Ear, nose, and throat (ENT) manifestations are very common along with the general symptoms. As anosmia and dysgeusia are early presenting symptoms in COVID-19 patients, all physicians should screen patients for ENT symptoms.

A cross-sectional study on knowledge, attitude, and practice of health-care professionals about adverse drug reactions reporting in a tertiary care teaching hospital of southern Rajasthan

Background: Adverse drug reaction (ADR) reporting is the integrity of healthcare professionals (HCPs) to counteract fatal outcomes aroused by the use of medications during therapy. The underreporting of ADRs imposes major problems globally. The pharmacovigilance program plays a key role in detecting and preventing ADRs. Targeting the upcoming younger generation of HCPs and sensitizing them towards ADR reporting in their clinical practice is essential. Aims and Objectives: The main objective of our study is to measure the knowledge, attitude, and practice of interns and postgraduates at our institute towards ADR reporting and pharmacovigilance. Materials and Methods: This study was a cross-sectional study conducted on interns and postgraduates of a tertiary care teaching hospital in Udaipur, Rajasthan. A set of 28 standard questions related to knowledge, attitude, and practice of pharmacovigilance and ADR reporting were distributed among 106 students after taking the ethical approval from the institute. The collected data were analyzed using SPSS (version 20) software in percentage. The Chi-square test (χ2) was used, and P &lt; 0.01* was considered significant statistically. Results: In our study, we found most of the participants were in 21–30 age groups (84.19%); male participants were (67%) in comparison with females (33%). The majority of interns showed their interest in participation (66%) rather than postgraduates (34%) in this study. The overall knowledge (14.645, P = 0.01), attitude (14.64, P = 0.01), and practice (35.712, P = 0.01) of HCPs were found to be significant. Conclusion: We conclude from this study that both interns and postgraduates have good knowledge of ADR reporting, but interns lack practice in their daily duties due to fear of heavy paper work, and postgraduates lack attitude towards ADR reporting due to heavy duty schedules. Most of the participants, i.e., interns and postgraduates, felt ADR reporting was their primary responsibility along with patient safety. Recurrent training and sensitization of upcoming medical professionals about ADR reporting will impart better patient compliance and eradicate fatal outcomes. They also suggest a separate working body needs to keep by institutions to collect the ADR reports during their busy duty schedules.

Occupational Exposure to Blood and Body Fluids among Healthcare Workers at a Tertiary Care Teaching Hospital: A Retrospective Observational Study

Occupational Exposure to Blood and Body Fluids among Healthcare Workers at a Tertiary Care Teaching Hospital: A Retrospective Observational Study

Awareness of medical students about the role of artificial intelligence in health care: A survey-based cross-sectional study

Background: Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially by computers. In the recent past, the utility of AI has been tested and proven in many fields like health care, education, finance, defense, etc. AI has received so much attention these days and is described as the new electricity and the fourth industrial revolution. It is anticipated that AI’s role will be crucial and imminent soon in different fields, including the health sector. The medical graduates need to update their knowledge and keep pace with the new developments in technology. Given this, our study was designed to evaluate the awareness and perception of medical students regarding the basic concepts of AI and its implications in health care. Aim and Objective: The aim and objective of the study are to assess the knowledge and perceptions of medical students about AI at a tertiary care teaching hospital. Materials and Methods: The study was a questionnaire-based, cross-sectional study. A prevalidated, self-made questionnaire was distributed to 264 medical students of all professional years through Google Forms. The student’s knowledge, opinions, and perceptions of AI were evaluated. The analysis of the collected data was done with an Excel sheet and using descriptive statistical measures such as mean and percentages. Results: Our study revealed that the majority of the students (79.16%) were under the impression that AI decreases errors in clinical practice. 86% of participants agreed that AI aids doctors in making accurate decisions in the diagnosis and treatment of different conditions. Around 72% of the students said that AI guides the patient to choose the right medical care. Onethird of the participants thought that AI hampers the relationship between patient and doctor by breaking trust between them. A few subsets of participants expressed concerns over ethical issues, confidentiality, empathy, and sympathy, which are considered to be the pillars of medical practice. Conclusions: Our study concluded that medical students at Mamatha Academy of Medical Sciences, Hyderabad, have positive perceptions and good awareness about AI and its use in health-care practice, but they still need a better understanding of AI.