Tertiary Medical College Hospital Research Articles

Histomorphological Spectrum of Pleural Biopsy Specimen of Exudative Pleural Effusion in a Tertiary Care Hospital in Bangladesh

Background: The commonest manifestation of pleural pathology is pleural effusion. Most of the time, in spite of routine biochemical and cytological examination of pleural fluid we can’t evaluate the etiology of pleural effusion. Aim: Aim of present study was to make an etiological diagnosis of exudative pleural effusion by pleural biopsy and histopathological examination. Study design and setting: Fifty consecutive patients of pleural effusion were selected from the outpatient and indoor department of a tertiary medical college hospital in Sylhet. It was a prospective and observational study. It was conducted over a period of one and a halfyears. Material and method: In all the cases, cytological examination of pleural fluid (for malignant cell) and pleural biopsy by Abram’s needle were done. Subsequently, histopathological diagnoses were made to determine the etiology of effusion. Results: Out of 50 subjects, males outnumbered females, Age is ranged between 19 and 85 years. According to the histopathological examination of the submitted pleural biopsy specimen, granulomatous inflammation is the most common etiology (40%) followed by chronic inflammation of non-specific origin (38%) and malignancy (22%). Conclusion: This study represents the result of the experience acquired over one and half years in the histopathological interpretation of pleural biopsies and its correlation with cytology of the pleural fluid. Pleural biopsy is a useful, minimally invasive procedure with no or little complication and has more sensitivity and specificity than pleural fluid cytology smears.

Infectious complications during the initial 225 cases of standard PCNL: A single center experience

Introduction: Percutaneous nephrolithotomy(PCNL) has emerged as the treatment of choice for medium to large urinary stones. Infection is a life threatening complication and is the most common cause of death following PCNL. This study aimed to examine different predictors of infective complications in PCNL. Methods: This retrospective study was done on patients who underwent PCNL between 2016 and 2020 at a tertiary level medical college hospital. Medical records were reviewed for study variables. Results: Two hundred and twenty five cases were included out of which 121 were male. A total of 151 complications were recorded among which 27(17.88%) were major complications. Infectious complications were seen in 67 (29.77%) patients among which 39 cases (17.33%) were febrile urinary tract infections. Urosepsis developed in four patients and one patient died due to urosepsis related complication. Female (p=0.003), Diabetes mellitus (p=0.002), positive urine culture (p=0.0001), stone location (p=0.01), degree of hydronephrosis (p=0.001), duration of surgery (p=0.001), number of access tracts (p=0.0001), and initial 100 cases (p=0.001) were associated with post PCNL infections. Conclusion: Female, Diabetes mellitus, preoperative urine culture positivity, stone location, degree of hydronephrosis, duration of the operation, number of access tracts and surgeon experience are risk factors for post PCNL infections. Surgeons should be extra vigilant during their initial period. Urinary tract infection should be treated and extra care should be taken when operating in female patients giving ample attention to preoperative investigations.

Current Status of Adverse Drug Reaction Reporting by the Physicians in A Medical College Hospital

Background: In order to improve the spontaneous Adverse Drug Reaction (ADR) reporting practice by the physicians, there is an obligatory need to investigate the current situation of ADR reporting by them. The study was conducted to observe the ADR reporting pattern among physicians in a tertiary medical college hospital.
 Materials and methods: This was a descriptive cross sectional study carried out in a tertiary medical college hospital during the study period of March 2020 to October 2020. Data were collected from 100 physicians working on different departments using self designed pretested questionnaire by convenient sampling technique.
 Results: Among the 100 respondents 70 provided response to questionnaire giving a response rate 70%. Most of the respondents (61.43%) had adequate knowledge on ADR reporting. A good number of respondents showed positive attitude but there is no practice of ADR reporting though most of the respondents (84.3%) had experienced it in last 1 year. Most of the respondents experienced ADR with antibiotic (81.35%), NSAIDs (33.89%) & anticonvulsants (15.25%) and maximum (44.06%) experienced ADR was with skin, 30.50% with GIT and 23.03% with respiratory system involvement. The cause of under reporting was mainly due to inaccessible ADR form, busy schedule, unaware of how and whom to report and lack of motivation to report. The respondents would be encouraged to report ADR if they were provided with simple & available reporting form, regular guideline & bulletin.
 Conclusion: There is an urgent need for educational training & seminar regarding our national online reporting system to emphasizing ADR reporting.
 Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 8-13

Usage of telecommunication technology in perpetration of sexual assault- A study conducted on reported victims in a Tertiary Medical College Hospital OCC

The sexual assaults and its consequences are increasing along with socioeconomic development of the country. Rise of modern communication technology add fuel to the flame. This descriptive cross-sectional study aimed to evaluate the role of communication technology in sexual assaults in Bangladesh. There were 87 victims included in this study. All were female of 6 years to 40 years of age, mean age was 15.67 (± 6.69) year. Most of the victims were below 20 years of age and came from low income families. About 76% mobile used were smart phone. Among them 46% were owned by the victims herself, 26% gifted by the assailants to the victims. Talking through mobile (37%) was the main communication route between the assailants and the victims; followed by direct verbal (31%), mixed verbal and mobile talking (26%) and others (6%). Regarding methods of communication, they only talk in 42% cases and 36% cases used mixed method (talking, SMS and video chatting). The assailant paid all the costs in 62% cases. Mobile phone came as a blessing in communication, but inchoate use makes it a curse to our society. Parents should be cautious about their children's mobile usage (especially smart phone) daily. Government also should make some policy on using mobile technology by the younger citizens.
 CBMJ 2020 July: Vol. 09 No. 02 P: 03-07

Device-Associated Hospital-Acquired Infections: Does Active Surveillance With Bundle Care Offer a Pathway to Minimize Them?

Background and objectiveThe prevalence of hospital-acquired infections (HAIs) is underreported in developing nations due to a lack of systematic active surveillance. This study reports the burden of device-associated HAIs (DA-HAIs) based on two years of active surveillance with in situ bundle care in closed intensive care units (ICUs) of a tertiary care hospital.Materials and methodsA prospective surveillance study was carried out in 140-bedded ICUs (2,100-bed hospital) of a tertiary care private medical college hospital. Daily active surveillance for catheter-associated urinary tract infection (CAUTI), ventilator-associated event (VAE), and central line-associated bloodstream infection (CLABSI) was done by trained infection control nurses (ICNs) along with quality champion nurses with HAI surveillance forms with bundle care auditing, which was attached to the case sheets of all patients on devices. The surveillance definitions of DA-HAIs were adapted from the Centers for Disease Control and Prevention (CDC)’s National Healthcare Safety Network (CDC-NHSN) 2017 surveillance criteria. Data were analyzed at the end of every month to generate the cumulative device-associated infection (DAI) rates and device utilization ratio (DUR). These data were compared with NHSN and International Nosocomial Infection Control Consortium (INICC) - India HAI rates and communicated to corresponding ICUs and also presented at the hospital infection control committee (HICC) meeting.ResultsThe surveillance data were reported over 71,877 patient days during the study period. The DUR of urinary catheters, ventilator, and central line were 0.53, 0.16, and 0.22, respectively. CAUTI, VAE, and CLABSI rates were 0.97, 10.5, and 0.43 per 1,000 device days, respectively. Among 166 DA-HAIs reported, 182 pathogens were identified. Klebsiella pneumoniae was the most common organism isolated, accounting for 37.4% of all DA-HAI cases, followed by Acinetobacter baumanii (30.8%). Most of the Gram-negative organisms were carbapenem-resistant (153/175; 87.4%). Vancomycin resistance rate in Enterococcus was 28.5% (2/7).ConclusionDUR and CAUTI, VAE, CLABSI rates were less/on par with the benchmarks of INICC and CDC-NHSN in almost all ICUs of our tertiary care unit. Gram-negative pathogen with 87.4% carbapenem resistance worsened the scenario. Proper active surveillance with bundle care and training by ICNs made a significant difference in all DA-HAI rates, especially VAE, which decreased to 10.5 from 23.6 per 1,000 ventilator days. Sustained active surveillance of HAI and bundle care auditing by a trained infection prevention team with a stringent antibiotic policy are the need of the hour to combat DAIs.

The Clinical and Spirometric Profiles and Staging of COPD, Asthma in Smokers and Nonsmokers, Bangladesh

Objective: In this study our main goal is to evaluate the clinical and spirometric profiles and staging of COPD, asthma in smokers and nonsmokers, Bangladesh. Method: This cross-sectional study was carried out at Tertiary medical College Hospital, Bangladesh. Where data were collected from July 2019 to June 2020. A total of 332 where 232 smoker having exposure to >10 pack year smoking fulfilling inclusion and exclusion criteria were included and 100 apparently healthy non-smoker also were included as control. Results: During the study, among smokers, clinically 11 and 5 were diagnosed to have COPD and asthma only and the spirometry also diagnosed these 9 smokers and other 31 smokers more to have COPD and thus diagnose 42 smokers to have COPD. Also, 9 smokers to have asthma. The difference between clinical and spirometrically diagnosis of COPD and asthma were statistically highly significant, 0.001. whereas, among non-smokers. Where among 100 nonsmokers only 2 have COPD and asthma. The value of FEV1 of smokers and non-smokers people were 3.1302 and 3.2450 respectively and their standard deviation were 0.52207 and 0.44162 respectively. This difference in FEV1 value was statistically significant (p value 0. 006. The value of FVC of smokers and non-smokers were 4.0857 and 4.2096 respectively and standard deviations were 1.47849 and 0.50218 respectively. Also, 56% and 50% had mild level of COPD and asthma severity. Conclusion: For long-term primary care smokers, these findings have major consequences. The advantages may include further reason for spirometry which might open the door to improved targeting due to variations in the appropriate therapy.

Evaluation of Risk Factors Associated with Vitamin D Deficiency in a Tertiary Medical College Hospital of Bangladesh

Objective: In this study our main goal is to evaluate the risk factors associated with vitamin D deficiency in Dhaka Medical College Hospital. Method: This cross-sectional study was carried out at Dhaka Medical College Hospital from January 2018 to Jun 2019. A total of 100 patients attending at OPD of various specialties with symptoms unrelated to gross vitamin D deficiency were included in the study. Results: During the study, majority of the cases were belonging to >24 years age group and 60% were female. 50% were service holder followed by 50% cases spent 3-6 hours in outdoor, 50% cases covered their body 60–80%.45% had vitamin D insufficient level and 33% had vitamin D deficiency level. Individuals who had a serum deficiency of 25-OHD had significantly lower calcium levels (9.25 ± 0.49, p ¼ 0.02), and those with insufficiency had significantly higher hemoglobin (14.3 [13.2e15.2] p < 0.001). There was a strong correlation found between gender; 0.03, educational level; 0.02 and number of hours spent outdoors; 0.01 with Vitamin D deficiencies. Conclusion: From our study we can say that, factors like, less outdoor activities, obesity or covering whole body, which could be responsible for more hypovitaminosis in case of female was not noticed. But it was very much clear that >24 years age group was the most vulnerable with highest level of hypovitaminosis-D. Some of these strategies include designing and implementing national programs for preventing and combating vitamin D deficiency, promoting healthy lifestyles and physical activity among the general public, as well as using vitamin supplements as a simple and cost-effective method.

Understanding and Analyzing Prescribing and Prescription Errors in Outpatient Setting of a Medical College Hospital ENT Department

Introduction A medication error is a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient. In the hospital OPD, errors can occur in deciding on the medication to be prescribed (prescribing error) or in writing the prescription (prescription error). Materials and Methods We analyzed 100 prescriptions and case sheets in the OPD of ENT department in a tertiary medical college hospital for a period of one week for errors and assessed the perceptions and attitudes of the residents of the department using a questionnaire. Result Several prescription writing errors were found, primarily failure to document non pharmaceutical patient advice and use of generic names. Four prescribing errors were noticed which did not need urgent intervention. Discussion Failure modes and effects analysis was done to rank the failures modes; and causes for failure were elucidated using Ishikawa Diagram. Recommendations for preventing errors were made based on these results. Conclusion This study illustrates the use of management techniques to identify errors and formulate appropriate preventive responses. Such techniques should be a part of ongoing departmental management; and they provide insights into improving resident training in an ENT residency program.

Determinants of minimum acceptable diet among young children in an urban slum: a community-based study

Background: Child health and growth deteriorate as a result of inadequate quantities and frequencies of complementary feeding.Methods: A community-based cross-sectional study was conducted in urban field practice area of a tertiary medical college hospital among 280 children by systematic random sampling method. Children belonging to 12-23 months were included while sick child, children whose mother/guardian did not give consent were excluded.Results: The proportion of children who met the minimum dietary diversity (MDD) and minimum meal frequency (MMF) were 52.8 % (95% CI) and 52% (95% CI), respectively. Out of 280 children, 90 i.e. (32.1 %) children had achieved the recommended Minimum acceptable diet (MAD). Maternal education (Chi square value=11.2; CI 95%); socioeconomic status (Chi square value=57.4; CI 95%) were positively associated with dietary diversity. Higher percentage of male children (44.8 %) achieved minimum acceptable diet as compared to female children (20.5%); (chi square value=18.8, CI 95%). The percentage of children receiving MDD and MMF was more among children of higher socioeconomic class (p value 0.0001) and from nuclear family (p value=0.45). The birth order of the child was inversely related to the attainment of MAD. (p value=0.0001).Conclusions: Results of the study strongly suggest that poor dietary diversity and meal frequency is associated with numerous factors and their interplay is a multitude of combinations rather than a single cause.

Detection of Pathogenic Microorganisms from Burn Patients Admitted in Tertiary Medical College Hospital and Their Antimicrobial Patterns

Object: To isolate and identify the microorganisms from the burn patients admitted to the National Institute of Burn and Plastic Surgery Unit in Tertiary Medical College Hospital, Bangladesh. A total number of fifty wound surface swab samples of first and second-degree burn patients were collected and the microbial analysis as well as the study of antibacterial susceptibility was conducted. The study showed the bacterial isolates were found. 45 (90%) of wound swab were positive among 50 and only 5 samples (10%) were negative in bacterial growth, which presented invasive burn wound infection from both sex age groups marked 12 - 60 years. The total viable count TVC-11651 CFU/plate was found and the highest amount in the second-degree burn patients. The results showed that Pseudomonas aeruginosa was common in all positive samples 6636 CFU/plate (57%) followed by Staphylococcus aureus 4070 CFU/plate (35%), Klebsiella spp. 450 CFU/plate (5%), Proteus spp. 243 CFU/plate (2%), and E. coli 162 CFU/plate (1%). Most of the pathogens were found to be drug-resistant while several isolates were noted to be multi-drug resistant. The growth of multidrug-resistant organisms should be considered as a serious risk factor in a burn unit. Aggressive infection control measures should be applied to limit the emergence and spread of multidrug-resistant pathogens.

Effectiveness of histopathological examination in medicolegal autopsies – A four-yearretrospective study from a tertiary level medical college hospital from South India

Histopathological examination (HPE) in medicolegal autopsies (MLA) is essential when gross examination is not sufficient to confirm or exclude morphological changes at cellular level. This study aims to evaluate the histopathological findings in medicolegal autopsies and determine the efficacy and effectiveness of HPE in MLA. A four years retrospective study was done from July 2015 to June 2019 and all cases of MLA which were sent for HPE to department of pathology were included in the study and clinical autopsies were excluded from the study. There were total of 364 cases with age range was between 0 to 86 years, with male female ratio of 1:1.09. Majority of the cases sent for HPE were for suicidal deaths by hanging which accounted 80.4% (293 out of 364 cases). Of autopsies done for cases other than suicidal hanging and strangulation, which were 63 cases, the most frequent organ submitted was heart (38 cases), followed by lungs (22 cases), liver(18 cases), kidneys (17 cases), brain (14 cases), spleen (13 cases), uterus (8 cases), intestine (6 cases), testes (2cases), pancreas and gall bladder (one case each). Overall significant findings were noted in any of the organs in 41 cases, did not show significant changes on microscopy in 7 cases, and showed autolysis in 15 cases. In our study HPE was more efficient in Lung (72.9%), followed by heart (36.3%). HPE plays an important role in establishing cause of death in MLA. It will be more fruitful when autopsy surgeon and histopathologist work together and autopsy surgeon clearly specifies what he is expecting or what he wants to exclude.

Stress, anxiety, depression, and resilience in cancer patients on chemotherapy

Background: Cancer chemotherapy is an intense and cyclic treatment that is associated with a number of distressing side effects that may affect the person's psyche. Aim: The aim of the study is to evaluate stress, anxiety, depression, and resilience in cancer patients undergoing chemotherapy. Materials and Methods: Consecutive cancer patients undergoing chemotherapy at a tertiary care rural medical college hospital were included in the study with their consent. Patients having comorbid medical or psychiatric disorders were excluded. Demographic and clinical characteristics of the patients were recorded. The Depression Anxiety Stress Scale and Abbreviated Connor-Davidson Resilience Scale were administered and scored as per the test manual. The data were analyzed using the SPSS software with t-test, Chi-square test, Mann–Whitney U-test, Spearman's correlation, and multiple regression analysis. Results: The study included 32 male and 68 female cancer patients on chemotherapy. Depression was found in 33 patients, anxiety was observed in ten patients while stress was present in three patients. Stress was positively correlated to anxiety and depression, while resilience was negatively correlated to depression. There were no gender differences in stress, anxiety, depression, or resilience. A multiple regression was run to predict depression from stress, anxiety, and resilience. These variables statistically significantly predicted depression, F (3,96) =55.075, P < 0.0001, R2 = 0.632. All three variables added statistically significantly to the prediction (P < 0.05). Conclusion: One-third of cancer patients on chemotherapy suffer from depression which is negatively correlated with resilience. Significant predictors of depression in these patients were stress, anxiety, and resilience. Psychiatric management in addition to reducing depression, stress, and anxiety should also aim to increase resilience in these patients.

Knowledge of Hypertension among Nurses at a Tertiary Medical College Hospital, Sylhet

Knowledge of Hypertension among Nurses at a Tertiary Medical College Hospital, Sylhet

Umbilical cord blood “How long does it last? Does it ever expire?”: A study on general population’s awareness

Introduction: A cord blood bank is a facility which stores umbilical cord blood (UCB) for future use in treating diseases of the blood and immune systems. Butit is not known how long cord blood can be stored and its cells remain viable. So, it is a big problem for the general public to go for storage and at the same time about the affordability of the unknown longevity and viability of UCB. In the present study, we tried to know the awareness among general public about the UCB and its longevity, viability and their affordability. Materials and Methods: The study was conducted in a tertiary level teaching hospitals NRI medical college and general hospital over one year period from Nov 2016 to Oct 2017, with ethical committee approval. Our study is a cross sectional study consist of 802 general public, based on questionnaire on 20 questions such as Age, sex, education, socio economic status, what is cord blood, its use, cost, longevity. Result: During our study period, out of 802 general public, 513(64%) were aware of UCBB (408 educated, 105 uneducated) and 289(36%) are unaware. 284 out of 449 (56%) people had knowledge about the cord blood storage longevity, which was more than 20 years and the lowest 5 to 10 years by only 30 aware people of 65(08%). Conclusion: The knowledge about, how long to store and its cost in uneducated people is poor. So local and central bodies related to health should give recommendation and guideline related to storage and usefulness to all people and health professional at grass root level. Keywords: Umbilical cord blood (UCB), Hematopoietic progenitor cells (HPCs), Hematopoietic stem cells (HSCs).

English

BACKGROUND Skin diseases and psychiatric illnesses are frequently found in the same patient. Although the psychiatric comorbidity of patients with dermatological conditions have been frequently studied, the prevalence of skin diseases in patients with primary psychiatric illnesses in India has not yet been extensively analysed. We hope to shed some light on the topic through this study and to gain insights into the co-morbidity of skin disorders in primary psychiatric outpatients. METHODS We have utilised a cross-sectional descriptive design for estimating the prevalence of skin disorders in primary psychiatric outpatients attending the outpatient department of a tertiary medical college hospital in India during the period from October 2019 to January 2020. Patients over the age of 18 years had been recruited for the study. Informed consent was obtained from all the patients. RESULTS A total of 135 patients were recruited for the study. 70 were males and 65 were females. The mean age of the participants was 38.6 years. A total of 88 patients of whom 46 were females had a co-existing dermatological condition that amounts to a prevalence rate of 65.1 %. Around 94 cutaneous manifestations were found among the 88 patients who had a dermatological disorder. CONCLUSIONS Skin disorders were highly prevalent in patients attending the psychiatric outpatient department. This points to a need for an inquiry and examination into skin related ailments in all psychiatric patients. KEYWORDS Psychodermatology, Comorbidity in Psychiatry, Skin Diseases in Psychiatry

Reconstruction of Orbital Floor Fractures with Titanium Micromesh: Our Experience.

The purpose of this study was to assess the use and accuracy of the titanium micromesh for primary internal orbital reconstruction in cases of either pure or impure orbital blowout fractures. Retrospective case series of 21 patients with a mean follow-up of 12months. Department of Dental Surgery of a teaching tertiary medical college Hospital. Twenty-one consecutive patients who underwent surgical reconstruction of orbital floor/or Combination of floor and rim fractures usingtitanium micromesh. Persistence of diplopia, orbital dystopia, implant extrusion, enophthalmos, infection, and complications. The recorded data included age, gender, cause of trauma, diplopia, enophthalmos, ocular motility, preoperative orbital PNS/CT, and postoperative paranasal sinus view skull preoperative and postoperative ophthalmological examination. Most of the patients were males and resulted from trauma inflicted during RTA, sport injuries or assault. The most Common fracture pattern was impure Blow out fractures, and commonly associated other facial fractures were midfacial fractures. Clinical examination along with diagnostic aids such as computed tomography of orbital fractures was used. Orbital floor exploration was performed in 21 cases due to functional or aesthetic deficits. All orbital floor bone defects required reconstruction. In these cases, orbital floor was reconstructed with .3mm titanium micromesh implant. We did not encounter any major complications related to the incisions or implant material, though sample size was small. The rate of complication in which correction was difficult (diplopia) was lower [4%, 1 case]. Titanium mesh gives excellent result in orbital floor fractures. Surgical anatomical landmarks knowledge is very important to prevent any intra- or postoperative complications.

Practice of storage, reuse and disposal of unused medications among semi-urban households of Northern Tamil Nadu – A Community Based Cross-Sectional Study

Medicine is a science of uncertainty and an art of probability. Inappropriate disposal of medicines may be harmful to the environment as well as mankind, at the same time improper storage is detrimental. Hence assessment of the ways of Storage, reuse and disposal of unused medications plays a key role. The objective of the study is to investigate the storage and reuse practices of unused medications and to gain insight on knowledge and attitude of proper disposal practices of unused medicines among semi-urban households in urban field practice area of Tertiary medical college hospital of northern Tamil Nadu. This study is a community based cross sectional study. A total of 243 study participants were enrolled using multistage random sampling method. Pretested semi-structured questionnaire is used for conducting face to face interviews. Procurement of medicines is mainly through pharmacy without prescriptions (40.32%), most of the families (42.8%) stored used and unused medications together. On inspection of drugs, 29.6% of expired medicines and 22.23% of medicines without labels were found. The predominant way of disposing medicines is disposal through garbage (51.4%). Addiction level is not much noted and negligible amount of people are aware of drug take back program (0.82%). Awareness must be created about wrongful procurement of drugs, and improper storage of drugs. Drug take back program must be initiated to reduce the improper disposal of drugs.

Concurrence of erectile dysfunction and coronary artery disease among patients undergoing coronary angiography at a tertiary Medical College Hospital in Goa

The paper is based on the data from 92 males less than 45 years of age who underwent coronary angiography at Goa Medical College during the period July 2018 to February 2019. The objectives include to estimate the prevalence of erectile dysfunction (ED) and its risk factors, and to evaluate the pattern of coronary artery disease (CAD) among these patients. The ED prevalence was 46.2%. Diabetes, hypertension and alcohol intake showed significant association with ED; and these patients were almost three more likely to have a coronary blockade compared to those not reporting ED. This concurrence between ED and CAD makes a strong ground for routine inquiry in sexual history of young males with one or more cardiovascular risk factors.

Urinary Tract Infection in Pediatric Patients on Clean Intermittent Catheterization via a Mitrofanoff port with Reused Catheters - Any Association with Catheter Sterility?

Objective:The objective of this study is to find out whether the reused catheters for clean intermittent catheterization (CIC) are colonized before insertion and its association with urinary tract infection (UTI).Materials and Methods:This is a study conducted on 28 pediatric surgery patients who are on CIC via a Mitrofanoff port and who were reusing catheters, in a tertiary care private medical college hospital for 6-month period. Catheters to be used for the next catheterization were sent for culture along with urine culture. A questionnaire was utilized to assess CIC practice and UTI.Results:Diseases of patients were: neurogenic bladder and exstrophy–epispadias and posterior urethral valve. Twenty-one of them had an augmented bladder. Hydronephrosis was present in ten and vesicoureteral reflux (VUR) in five. Their mean duration of CIC was 5.3 years. Of 28 catheter tip samples, 16 catheters were colonized with organism. Of the 28 urine culture samples, 17 cultures were positive and all were asymptomatic except one. Of the 16 positive catheter samples, only 9 had positive urine culture; four of them had grown different organisms and five of them had the same organism, and even in these five, single organism was seen only in three. Urine culture grew Gram-negative organism in 85%, but catheter grew Gram-positive organism in 46%. No difference was found in the variables between both groups such as hydronephrosis, VUR, and augmented bladder.Conclusion:Reused catheters were colonized in 57% of the study patients, but reused catheter may not be the cause of culture positivity or UTI in the study population.

Assessment of adolescent behavioral and psychologicalproblems using Strength and Difficulties Questionnaire(SDQ) in select schools of Bengaluru

Background Among 243 million adolescents in India 10-20 is estimated to have psychological disorders. Many cases are not detected and screened due to lack of awareness and because of health departmentrsquos singular focus limiting to their reproductive and physical health. This has contributed extensively to the increasing psychiatric morbidities in the adults over the years.Objectives To compare the psychological and behavioural problems of adolescents in a rural and an urban school using Goodmanrsquos Strength and difficulties questionnaire.Methodology A cross sectional study was conducted at rural and urban schools located in field practice area of Department of Community Medicine Tertiary medical college hospital Bengaluru. Data was collected after taking written consent from head of institution and oral assent taken from students. SDQ Strengths and Difficulties questionnaire a predesigned questionnaire was used for data collection. The study lasted for a time period of June to September 2019. Results were analyzed using SPSS version 20.Results T-SDQ scores were normal close to average in 68.33 of rural amp urban study population. 17.66 Males were found to be having higher scores when compared to 15 females. Mean and SD scores of Peer conduct emotional problems were found to be higher in rural study population i.e conduct problems 3.73plusmn1.805 peer problems 3.73plusmn1.744 Emotional problems 3.73plusmn2.481 thereby resulting in overall high Total SDQ scores 14.15plusmn5.151.Conclusion Our study has reported that 24.99 of adolescents were having more than high scores. Therefore there is need to counsel and develop rapport with the students as well as parents regarding the Psychiatric morbidities and problems. And train the teachers and parents to regularly use SDQ to assess the students and identify the hidden problems while doing so.