Tertiary Health Care Setup Research Articles

Comparison of Research Knowledge in Postgraduate Trainees of Clinical and Basic Health Sciences of a Tertiary Healthcare Setup: A Qualitative and Quantitative Assessment

Comparison of Research Knowledge in Postgraduate Trainees of Clinical and Basic Health Sciences of a Tertiary Healthcare Setup: A Qualitative and Quantitative Assessment

Attitude toward body donation among the non-medical support staffs in a tertiary care center of Eastern India

Background: Anatomy is a basic fundamental subject of medical science. Cadaveric dissection is an essential part of the anatomy teaching-learning process to provide detailed in-depth knowledge about the structural organization of organs in human the body to medical students. Human cadavers are mainly obtained by the body donation program, but the rate of body donation is not adequate in various parts of the country. Aims and Objectives: This study was conducted to assess the attitude toward body donation among the non-medical support staffs in a tertiary health care setup in Eastern India. Materials and Methods: After ethical approval was obtained, a face-to-face interview was conducted among 151 non-medical support staffs using a structured questionnaire. The data were analyzed using Microsoft Excel and Epicollect5 software. Results: This study revealed that 44.37% of the participants were willing to donate their bodies for medical science after their death. The willingness was relatively higher among the male population, with urban residence, higher education level, and higher income group. The main motivation toward body donation was to help society by helping medical science. The main reason behind unwillingness was being uncomfortable about donating own body. Conclusion: Target-oriented awareness program could be conducted to increase motivation toward body donation. Publicly acknowledging the body donors and showing respect to the cadaver and donor family might increase willingness toward body donation.

Determining the Mean Dermatology Life Quality Index of Skin of Color (SOC) Patients With Vitiligo: A South Asian Perspective.

Vitiligo has a special significance to the skin of colour (SOC) population because depigmentation is more obvious in the SOC population. As a result, vitiligo exerts a huge stigma on the affected individuals. The literature so far has reported on the health-related quality of life (QOL), including the dermatology life quality index (DLQI), and has demonstrated the profound effect of vitiligo on a patient's QOL. Those affected by vitiligo are found to have lower self-esteem when compared to the non-affected individuals. The impact on the SOC population is even graver and underrepresented. Thus, the objective of this study was to report the mean DLQI in vitiligo in SOC individuals. This descriptive, cross-sectional study was performed in the dermatology outpatient department of a tertiary healthcare setup in Rawalpindi Pakistan. A total of 113 patients suffering from vitiligo, aged 15 to 65 years, both male and female, were included in the study. In all the cases, the DLQI score was noted. With the age ranging from 15 to 65 years and a mean age of 34.96 ± 9.59 years, 70% (n=77) of the patients were between 15 to 40 years of age. The male-to-female ratio was 1:1.3, with male patients comprising 38.21% (n=47) and females being 61.79% (n=66). The mean DLQI score of the vitiligo patients in our cohort was 9.39 ± 6.35. This study concluded that the mean DLQI score was higher in female patients and in vitiligo universalis patients, compared to other variants of vitiligo. The SOC population affected with vitiligo is at a higher risk of having a decreased QOL and hence may need special attention with regard to quality health delivery services.

IJCM_332A: Factors affecting quality of life among antenatal women seeking health care in tertiary care hospitals of Mangaluru

Background: QOL is defined as “individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.” Pregnancy is a physiological state associated with several emotional and physical changes, and the antenatal period is the moment of preparation of the woman for the childbirth and maternity. Thus, poor quality of life can have adverse effects on mother and the fetus. In order to develop methods to improve the quality of life of pregnant women, the factors affecting it should be understood; and our study aims at providing such understanding. Methodology: A hospital based Cross-sectional study of the pregnant women seeking antenatal health care in Government Lady Goschen Hospital and KMC, Attavar. The data collection was done from 14-03-16 to 31-03-16 using a questionnaire consisting of 4 parts-participant details, WHO QOL- BREF, QIDS and modified Kuppuswamy scale. Results: The study was done among 195 pregnant women, and the mean QOL-BREF score was found to be 73.60. 60.5% participants belonged to lower socioeconomic status, and had a lower QOL in physical, psychological and environmental domains. 54.6% participants showed symptoms of depression and had a lower QOL in physical domain. Other factors like parity, history of abortion and complications in the current pregnancy did not show a significant association with QOL score. Conclusion: The QOL of antenatal women seeking health care in tertiary health care setup was found to be good. The factors that significantly affected the quality of life were depression and lower socio-economic status. They had a negative impact on the quality of life.

Prevalence of Periodontal Disease among Patients Reporting to Tertiary Care Hospital in Ranchi.

Despite a huge number of advancements in the medical field, periodontitis still remains one of the most prevalent oral diseases worldwide. Thus, the primary aim of our study was to evaluate the prevalence of periodontal diseases in patients reporting to the tertiary healthcare setup in Ranchi. Based on inclusion criteria, subjects aged 18-60 years were selected and a per forma was filled by the observer. The prevalence of periodontal disease was measured using the community periodontal index, simplified oral hygiene index, and stage of periodontitis. Descriptive variables were assessed using frequency, percentage, mean, and standard deviations, while the categorical analysis was performed using the Chi-square tests. General awareness about periodontal health and regular dental visits should be given utmost importance among the rural populations of every developing country.

Psoriasis and Risk of Migraines in Patients Reporting to a Tertiary Care Setup in Pakistan: A Cross-Sectional Study

Objective: To look for migraine headaches and associated factors in patients being managed for psoriasis at a tertiary healthcare setup in Rawalpindi, Pakistan. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2021 to Feb 2022. Methodology: One hundred and forty patients of psoriasis being managed at our Dermatology Unit were included in the analysis. All patients were screened with the Migraine Screen Questionnaire (MS-Q), and those having scores equal to or more than four were evaluated by medical specialists, and diagnosis of migraine was established based on the International Classification of Headache Disorders diagnostic criteria for migraine. An association of relevant risk factors was established with migraine among these patients. Results: Out of 140 patients with psoriasis, 75(53.4%) were male, while 65(46.6%) were female. Eighty-five (60.7%) patients had migraine confirmed by clinical criteria, while 55(39.3%) had no migraine. Statistical analysis revealed that more body surface area involvement and longer duration of psoriasis had a statistically significant relationship with migraine among the study participants (p-value <0.05). Conclusion: The study showed that patients with psoriasis had an approximately 3-fold increased risk of migraine headaches compared to the normal population. Most of the patients had migraine without aura. Patients with longer duration of psoriasis and those with more surface area of the body affected with psoriasis were at an increased risk of migraines compared to other patients.

Correlation between Hepatitis B Viral Load and Hepatitis B Surface Antigen Levels in Asymptomatic Seropositive Blood Donors

Background and Objectives: Correlation has been shown between hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) levels in different patient categories. However, this has not been studied for donors. The aim of this study was to study the relationship between HBV DNA levels and E ratio obtained for HBsAg testing by chemiluminescence immunoassay (CLIA) performed on donor samples. Methods: A prospective, observational study was conducted in the department of transfusion medicine at a large tertiary health-care setup in North India from 2017 to 2021. Serological testing for HBV included HBsAg testing by CLIA. All reactive samples were tested in duplicate by electro CLIA (eCLIA). All samples found to be reactive in all three tests were then tested by a rapid diagnostic test and quantitative polymerase chain reaction. Results: During the study duration, 251 donors were found to be reactive for HBsAg by CLIA and eCLIA in screening. Of these 251, HBV DNA could not be detected in 85 (33.86%) samples, whereas in rest 166 (66.14%) samples, HBV DNA was detected. Mean E ratio for CLIA for all 251 samples was 5177.45, whereas mean viral copies detected were 19645858.66. The correlation for all 251 samples was found to be weak negative. The correlation for sero-reactive samples with the presence of HBV DNA was also found to be weak negative. Conclusion: In conclusion, we found significant but weak correlation between HBsAg results obtained by CLIA and HBV DNA levels for blood donors. The measurement of HBV DNA level is necessary for all apparently healthy donors coming for blood donation and testing reactive for HBsAg in screening assays.

Scope of medical rigid thoracoscopy in patients with pleural effusion of unknown etiology: A prospective single center study

Background: Pleural diseases commonly encountered are pleural effusion, pneumothorax, pleural wall thickening, and pleural mass. Medical thoracoscopy is a minimally invasive procedure that allows diagnostic and therapeutic intervention. The medical diagnostic thoracoscopy in local anesthesia is a simple, low-cost investigation with relatively high diagnostic accuracy, no mortality, and low morbidity. A diagnosis of pleural tuberculosis (TB) could be achieved in 99% of patients as against 51% using closed pleural biopsy. Aims and Objectives: Assessment of the role of medical rigid thoracoscopy in patients with pleural effusion of unknown etiology in a tertiary health care setup. The primary objectives of the study were to evaluate the diagnostic yield of medical thoracoscopy in pleural effusion of unknown etiology. Materials and Methods: The study duration/time frame to address the study: November 2017–February 2019 sample size with Justification Sample size: Minimum 31 patients. It was a prospective observational study. All patients admitted in hospital/daycare at LHRC presenting with pleural effusion with unknown etiology. All patients had a medical thoracoscopy, and samples were sent for microbiological and histological analysis. Clinical, thoracoscopic results and histopathological data of the patients were collected prospectively and analyzed. Results: In this study, 28 patients out of 31 patients were diagnosed. The diagnostic yield of thoracoscopic pleural biopsy was 90.3% Out of 31 patients, the most common complication found was chest pain 48.4% (15/31), followed by 09.7% (03/31) of the cases had complications such as surgical emphysema, postoperative fever, and bleeding. There were no complications in 32.2% (10/31) patients. Conclusion: Medical thoracoscopy is a noble procedure that helps the pulmonologist/surgeon to inspect the pleural cavity. It is a safe and effective diagnostic as well as a therapeutic tool with a high diagnostic yield. The most common differentials of undiagnosed pleural effusion cases are TB and malignancy.

Effect of Sodium Hypochlorite on Biofilm-Producing Organisms Isolated from A Hospital Drinking Water

Objectives: Providing safe drinking water is essential for maintaining healthcare quality. The presence of biofilms in the water supply protects the organism from the antimicrobial effects of disinfectants leading to the formation of the MDR pathogen pool. Therefore, this study was taken up to determine the prevalence of biofilm formation in the bacteria isolated from the water system of a tertiary health care setup and study the effect of disinfectants on biofilms.
 Methods: Thirty-four drinking water samples were collected in sterile glass stopper bottles and transported to the lab. Standard bacteriological procedures identified isolates. Biofilm detection was carried out by the tissue culture plate (TCP) method. The effect of disinfectant (sodium hypochlorite) at various concentrations (0, 0.25, 0.5, 1, 2, and 4 %) on biofilm-producing organism were studied for 30 minutes and analyzed.
 Results: The culture positivity was 76.4% (26/34). Twenty samples showed monomicrobial growth, while only six samples showed polymicrobial growth of organisms. The most common organism isolated was Pseudomonas aeruginosa. Biofilm production was seen more in polymicrobial organisms, 91.66 % (11/12). A high level of resistance to chlorine compounds was seen in biofilm-producing microorganisms, especially those that produced robust biofilms.
 Conclusion: Resistance of biofilms against high levels of chlorine has implications for the delivery of safe drinking water. Drug resistance was seen in these organisms, which can be transmitted from drinking water sources to humans. Therefore, it is recommended that biofilm production should be evaluated in drinking water samples regularly..J Microbiol Infect Dis 2022; 12(4):17-24.

Clinico-Investigative Profile of Prolonged Hyperbilirubinemia in Newborns Presenting to Tertiary Health-Care Setup in Rural Maharashtra

Introduction Prolonged hyperbilirubinemia is defined as high bilirubin levels (>10 mg/dL) persisting beyond day 14 of life in term neonates and beyond day 21 in preterm neonates. Methods and Material A prospective cross-sectional study was conducted at a rural tertiary care hospital after obtaining an ethical approval and an informed consent. All infants under 6 months of age with hyperbilirubinemia after 21 days in preterm and 14 days in term were included. This study was designed to determine the proportion of prolonged hyperbilirubinemia and its causes and investigative profile in rural tertiary care. Results Out of total infants showing hyperbilirubinemia, 30.51% of patients had conjugated hyperbilirubinemia with female predominance, whereas 69.49% had unconjugated hyperbilirubinemia with male predominance. In our study, 38.14% were diagnosed with breast milk jaundice, followed by 33.90% caused by septicemia and 10.17% cases of cephalhematoma. In addition, hypothyroidism and TORCH infections were observed in 4.24% of cases, whereas a single case of cystic hygroma, subdural emphysema, pyloric stenosis, and G6PD deficiency was seen. In comparison, late-onset hemorrhagic disease of newborns was observed in 3.39% of cases. Conclusion Breast milk jaundice was the most frequently encountered etiologies of prolonged hyperbilirubinemia and hence, unnecessary investigation for unconjugated hyperbilirubinemia should be avoided.

Analytical and clinical performance evaluation of enhanced chemiluminescence-based fourth-generation HIV combo assay: Report from tertiary health-care setup in North India.

HIV fourth-generation assay, designed for the detection of HIV p24 antigen along with anti-HIV antibodies of both immunoglobulin M and immunoglobulin G type against HIV 1 and HIV 2 viral antigens, have helped in the early detection of HIV infection and supports in minimizing the transmission risk in the acute phase of infection. The objective of this study was to evaluate the analytical and clinical performance of HIV fourth-generation assay based on enhanced chemiluminescence technology. The analytical performance of the assay was evaluated in terms of accuracy, precision, limit of detection, type of sample (serum vs. plasma), cross-reactivity (with other transfusion transmissible infections markers), and interference (with endogenous substances). Proficiency control material included kit-controls, archived known positive donor samples, third-party controls, and World Health Organization (WHO)/National Institute for Biological Standards and Controls (NIBSC, MHRA, UK) controls. The clinical performance was evaluated using routine donor and patient samples received during the study period. HIV fourth-generation assay showed reliable and reproducible results measured in terms of coefficient of variation % with kit-controls, archived known positive donor samples, third-party controls, and WHO international standards for anti-HIV 1 and 2 antibodies, HIV1 p24 antigens and HIV2 p26 antigen controls. The analytical sensitivity of the HIV fourth-generation assay was found to be 0.1 IU/mL of HIV1 p24 antigen control and there was no cross-reactivity or interference observed. In the clinical performance of the assay, HIV fourth-generation assay showed reliable performance in both donor and patient samples. HIV fourth-generation assay meets the requirements for its use as a screening assay for HIV infection based on the analytical and clinical performance of the assay.

Gynaecological Complications in General Surgery Unit: A Single-Center Study

Introduction: This study aims to investigate the frequency of gynecological complications reported during emergency and elective general surgeries. Methodology: This is a cross-sectional study, data were collected retrospectively, approximately 500 patients went through surgical management in the general surgery department while only 125 reported associated issues requiring surgical management and required gynecological interventions. Data was entered & analyzed using SPSS version 22. Frequency and percentage were calculated for quantitative variables such as presenting complaints, reported gynecological issues, required intervention, and reported associated problems. Results: A total of 125 patients were enrolled in the study with the most commonly reported presenting complaint being pain with the vaginal discharge with vomiting documented in 72(57.5%) of patients. Puss discharge from wounds, peritonitis, and abdominal swelling were other frequently reported issues in 14(11.2%), 11 (8.7%), and 11 (8.7%) patients respectively. 98(78%) were discharged after successful management of gynecological as well as general surgical problems, 25(20%) were referred to tertiary care health care setup for more appropriate care and 1(1%) had a burst abdomen. Only 1 (1%) out of 125 patients expired during the study period. Conclusion: Gynecological complications have been markedly reported in the general surgery unit, necessitating general surgeons to intercede and deliver significant benefits in terms of lowering morbidity, mortality, postoperative complications, and length of hospital stay from a diagnostic and therapeutic point of view.

Aggressive management of extensive de gloving injury of the left lower limb with debridement and split skin grafting and application of vacuum-assisted closure system over recipient grafting site in a tertiary health care setup

Aggressive management of extensive de gloving injury of the left lower limb with debridement and split skin grafting and application of vacuum-assisted closure system over recipient grafting site in a tertiary health care setup

Comparison Between Functional Outcomes of Bone Patellar Tendon Bone Autografts versus Semitendinosus Autografts for Reconstruction of Anterior Cruciate Ligament

Purpose: Our study of comparison of functional outcomes and complications of bone patellar tendon bone autograft and semitendinosus autograft for Anterior Cruciate Ligament reconstruction. Material and Methods: 60 patients were operated for ACL reconstruction in a tertiary health care setup, out of them 30 were operated with semitendinosus graft and 30 were operated with bone-patellar tendon-bone graft and were reviewed at 3 months, 6 months, 9 months and 12 months. After the procedure, the patients were assessed for the functional outcome using Tegner-lysholm knee scoring scale and also with International Knee Documentation Committee (IKDC) Scoresat. Results: Mean lysholm score was comparable between STA and BPTB groups at baseline (41.50 vs 41.77; p-0.81). The mean scores significantly improved in both group at each follow up and was recorded as 93.43 and 90.6 by the end of one year in STA and BPTB group respectively. The improvement was slightly better in STA group at each follow up. Conclusion: Arthroscopic/open anterior cruciate ligament reconstruction by either semitendinosus autograft or bone patellar tendon graft gives satisfactory results in short term follow up in terms of knee functions. However, Rehabilitation with bone patellar tendon bone autografts group was accelerated in balance proprioception and running as compared to semitendinosus autografts also creep of graft is mostly seen in semitendinosus autografts which is less likely to be seen in bone patellar tendon bone autografts.

To Study Functional Outcome for Upper Limb Phalanx Fracture Treated by JESS Fixator

Purpose: To study functional outcome for upper limb phalanx fracture treated by Joshi’s External Stabilizing System (JESS) fixator. Material and Methods: 68 patients were operated for Upper limb phalynx fracture in a tertiary health care setup with JESS fixator and were reviewed at 3 weeks, 6 weeks and 3months. After the procedure, the patients were assessed for the functional outcome using DASH (Disabilities or Arm, Shoulder and Hand) scoring scale. Results: Mean Adjusted DASH scores of the operated finger over consequent visits at 3 weeks, 6 weeks, and 3 months. We found that the mean adjusted DASH score improved in each consequent visit as compared to the first visit for all the joints (p<0.001). Out of the total 68 study participants, 63 had no complications (92.65%). Only 5 study participants had complications, out of which 2 each had joint stiffness (2.94%) and superficial pin track infection (2.94%) while 1 had pin loosening (1.47%). Conclusion: From the results, we can safely conclude that JESS is an effective alternative treatment for fractures of the phalanges. It is cheap and easily available. Technically, also it is less demanding. Also there is a good functional outcome as suggested by our study findings in terms of improvement in the range of motion as well as the mean adjusted DASH scores over a period of three follow up visits planned at 3 weeks, 6 weeks and 3 months with very few complications.

Influence of social, physical & antenatal stresses in perinatal women of tertiary health care setup during COVID-19 pandemic

Corona Virus-19 had a detrimental effect on people's ability to live a healthy and active lifestyle. Social life is impacted by this outbreak, resulting in anxiety and psychosomatic illness. The purpose of this study is to determine the effect of social, physical, and psychological factors on perinatal women enrolled in tertiary health care facilities established during the COVID-19 pandemic. At Saifai' tertiary level hospital, a cross-sectional observational study was conducted. A questionnaire calibrated on the Likert scale was administered to 72 inpatient perinatal mothers to assess their levels of anxiety (n=04), social network dependency (n=03), and quality of life (n=02). Physical characteristics were derived from baseline data. Each section's scores were added together. Group C has the highest mean anxiety level, followed by Groups D, A, and B. When compared using one-way ANOVA, the results are statistically significant at p<0> Keywords: COVID-19 pandemic, Perinatal women, Physical, Psychological, Social factors.

Isolated Pattern of Microorganism among Pediatric Patients with Ventilator-associated Pneumonia (VAP) in a Tertiary Care Hospital Karachi

Background: The Ventilator associated pneumonia (VAP) is a common condition with inflammation of lungs. The patients on mechanical ventilation or artificial breathings for 48 to 72 hours tend to developed this condition., which is a type of Nosocomial Pneumonia.
 Objective: To assess the causative agent and treatment pattern among the patients suffering from ventilator associated pneumonia.
 Methodology: A cross sectional study was conducted for the period of 8 months at a tertiary health care setup of the Karachi Pakistan among the patient’s with VAP. Total of 72 patients with confirmed diagnosis of VAP were included in the study. Data was collected from the children intensive care units on a structed questionnaire. The required variables were obtained from the patients files/Records after the ethical approval was obtained before the collection of data Results were evaluated using the SPSS version 20.0.
 Results: The study found out that the VAP is most type of hospital acquired pneumonia form the health care system., showed 59.8% (n=61) males and 34.3% (n=35) females’ patients with VAP diagnosis. The age group revealed majority of the patients 46.1% (n=47) were 0–1-year-old, 11.8% (n=12) patients were above 2- 3 years old. 18.6% patients (n=19) were >3 years-4years old. The study also assesses ventilators support >48 hours have around 20-30% (Mean 6.9 days CI: 1.16-3.65) chance to develop the VAP. The subsequent effects of VAP shows the two-fold rates of mortality hence requiring the more length of stay at hospital and extra charges.
 Conclusion: The VAP occurs among the considerable numbers of patients on the ventilator supports, the findings suggests that an appropriate management, prevention strategies and effective treatment is needed to reduces the mortality and complications of VAP.

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Background:Life event research is the cornerstone for assessment of psychosocial factors causing stress and illness. Somatoform disorder is a chronic debilitating illness and stress increases disability in it. Yet, studies in this area is sparse.Aim of the study:The aim of this study was to assess if there is an association of stress with depression in patients of somatoform disorder.Materials and methods:A hospital based cross sectional study was conducted in a tertiary healthcare setup of Assam. The sociodemographic and clinical variables of patients of somatoform disorder diagnosed as per ICD-10 were collected. Stress was assessed using the presumptive stressful life events scale and severity of depression was evaluated in patients with co-morbid depression using HAM-D scale.Results:Majority were between 50-60 years of age (32%), home-maker (28%), from rural area (58%) and had presented with a duration of illness between 0-5yrs (43%) and 30% belonged to the somatization disorder group. Depression was present in 55% and mild depression was most common. Financial stress was most commonly reported stressful life event; stress was found to have a strong positive correlation to presence and severity of depression (p-value<0.01). ‘Presence of unmarried adult son/daughter’ as a self-reported life stressor was a novel finding in this study.Conclusion:Presence of stress amplifies the chances and severity of depression in patients of somatoform disorder. Thus, management of stress is an integral part in management of these patients.

Feasibility of COVID-19 oral health care guidelines in day to day practice: Our experience in a tertiary care hospital

The COVID-19 has spread throughout the world since December 2019 and brought the delivery of the oral health facilities to a standstill. Customization of oral health care guidelines during the COVID-19 pandemic at the dental division of a tertiary health care setup in India. Existing literature was searched regarding any available information regarding oral health care guidelines at the tertiary health care set up. Further, various health regulatory authorities' websites were searched for guidelines related to COVID-19 and patient management and infection control. Adhering to the health regulatory protocols for COVID-19, a total of 24548 patients were provided with dental consultations and various dental procedures, including teeth extraction, orthodontic interventions, teeth restoration, root canal treatment, and oral prophylaxis, major and minor oro-maxillofacial surgeries from April 1, 2020, to August 31, 2021. Emphasis was on providing a safe working environment to the oral health care team and the patient. None of the members of the dental health team became positive for COVID-19 during the study. On the basis of our experience, we highlight that it is very much possible to efficiently and effectively treat the patients which oral health care during and post-COVID-19 pandemic. Frequent change in the guidelines regarding COVID-19 infection by various authorities, so keeping an eye on the same is also advised because various aspects of COVID-19 infection are yet to be confirmed and brought to the light. In our setup, patient satisfaction was good among the treated patient, and they applauded the efforts put by our team.

Study to Assess the Status of Hepatitis B Vaccination and Factors Affecting Antibody Titers Level for Hepatitis B to Various Health Care Workers and Medical Students in Tertiary Healthcare Setup in Himachal Pradesh

Background: Hepatitis B(HBV) is one of the most important occupational hazards among the medical student and healthcare workers(HCW's) due to risk of exposure to infected bodily fluids and blood. This study aimed to assess status of HBV vaccination and factors affecting anti-HBs titres levels for HBV in HCW and medical students. Material and Method: It was a prospective, descriptive and cross sectional study done at the Department of Microbiology, DRPGMC Kangra at Tanda(H.P). Randomly 215 HCW’s and medical students were taken in the study who fulfilled the inclusion criteria. Results: Total of 215 subjects were included in the study. Males were 89 and females were 126. 182 subjects were vaccinated and 33 were unvaccinated for hepatitis B. Out of 182 vaccinated 137 were completely vaccinated. Significant correlation was seen with decrease in antibody titers with gender, duration of vaccination and smoking. Conclusion: Vaccination should be mandatory for every HCW and medical student entering the health institutions. The factors affecting the antibody titers must be evaluated and antibody titers must be reviewed from time to time. The need for a booster dose can be made mandatory at least for healthcare professionals. Keywords: Hepatitis B virus, Vaccination, Antibody titers, HCW.