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Purpose: To assess the perception of college-going girls toward corneal donation in Northern India. Methods: An online survey with a pre-structured, pre-validated questionnaire was conducted on 1721 college-going girls in Northern India. The knowledge and attitude scores were regressed, and latent class analysis was carried out. Results: The average of scores for all participants was computed individually for the knowledge questions and the attitude questions, and based on this score, total participants were divided into two groups: Better corneal donation behaviors (BCDB) and poor corneal donation behaviors. The binomial logistic regression model of knowledge domain for predicting BCDB, age of the participant, their awareness about corneal donation, and willingness to discuss eye donation among family members were found significant. Similarly, for the attitude domain, awareness about corneal donation, knowledge about hours within which ideal eye donation needs to be undertaken, and knowledge about eye donation during coronavirus disease 2019 (COVID-19) pandemic were found to be significant. Latent class analysis identified one subset of participants having poorer knowledge and attitude scores and that they were more from a rural background, were having more than first order as birth order, were belonging to SC/ST classes, had illiterate or secondary education of father and mother, and were living in rented houses. Conclusion: The findings of the study significantly contribute to devising a mechanism to improve knowledge and influencing the attitude about eye donation among the youth, especially young women, who can act as counselors and motivators for the masses as well as their own families, in the generations to come. [ABSTRACT FROM AUTHOR]

Background: Health care linen is a source of healthcare-associated infections. Hospital laundry services play a vital role in linen decontamination. Effective laundry is essential in preventing hospital-acquired infections, especially in multidrug-resistant organisms. Aims and Objectives: The study aimed to check the microbial load in linen after the laundry process and the during the supply chain in the hospital. We investigated the bacterial load in linen before and after the laundering process and the linen from stored linen banks. Materials and Methods: Linens (n=125) from the hospital were collected in different stages of the laundry process [31 linen before decontamination; 94 linen after decontamination (Post washing = 30; Linen Bank = 34; Ward 30)]. A square inch of linen from each linen was vortexed in normal saline, and colony forming units (CFU)/inch of linen were calculated using appropriate media. The identification and susceptibility of organisms were performed using MALDI-TOF MS and CLSI disk diffusion methods, respectively. The difference in the load of the organism was analysed between different stages of the laundry and storage process. Results: We found that100% of pre-decontamination linen harbour viable organisms (22.59% including multidrug-resistant pathogenic organisms: MDROs), which decreased to 40% (no MDROs) postdecontamination. The overall load was reduced by a factor of 103.77. Conclusion: The microbial contamination of linen is common, and there is an urgent need to develop consensus on the microbial examination frequency and acceptable range of organisms on hospital linen worldwide. [ABSTRACT FROM AUTHOR]

The article describes the case of a six-year-old male with fever for four days, vomiting, and altered sensorium for two days and was diagnosed with acute necrotizing encephalopathy (ANEC) associated with dengue infection. Topics discussed include clinical characteristics of ANEC, basis of the diagnosis, and proposed diagnostic criteria for ANEC.

Background: Varicella–Zoster virus (VZV) infection in healthcare organizations, especially in intensive care units (ICU), having admitted immunocompromised patients, is of serious concern as well as poses threat to healthcare workers working in such critical areas. The present report defines the transmission and infection control measures initiated to curtail VZV infection spread in the trauma ICU of a tertiary care hospital of North India. Outbreak Report: At the infection outset, there were 12 patients admitted in ICU and 54 healthcare workers were posted to manage these critical patients. After confirmation of VZV infection, all susceptible patients as well as healthcare workers were quarantined and fresh intake of patients was restricted. Out of the total healthcare workers, 14 (25.92%) were found susceptible (as per protective VZV IgG titers) and were vaccinated. Of the 12 patients admitted in the ICU, six patients were discharged and sent home directly, four patients expired due to their critical disease state, one patient left against medical advice, and one patient remained admitted in ICU till the incubation period was over. Epidemiologically, line listing for index case reporting was done. The efficacy of control measures was re-evaluated to strengthen existing infection control practices and general measures viz. strict hand washing, adherence to aseptic protocols and intensification of environmental cleaning. Conclusions: Established varicella surveillance measures ensure VZV outbreaks are identified in a timely manner and control measures implemented to prevent further transmission. Also, vaccination policy among HCWs is the utmost requirement despite having huge financial implications. [ABSTRACT FROM AUTHOR]

Disaster incidents leading to massive obliterations often bring to the forefront the inadequacies of the systems, infrastructure as well as personages. In healthcare settings, these imperfections are usually exhibited specifically during fire disasters. This case report details a true fire incident that erupted in a patient bed-head panel of an emergency complex room and describes the real-life challenges encountered by the emergency staff in preserving both life and property. Bed-head units encompass both electrical and medical gases: a structural component quite common in modern hospitals. Precautionary measures should be implemented to mitigate such incidents, as well as specific attention, should be made during the designing and installation of these bed-head panels. Better coordination, scheduled training, and fire drills can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby, making a safer healthcare environment for every worker and patient. [ABSTRACT FROM AUTHOR]

CONTEXT: The outbreak and spread of severe acute respiratory syndrome coronavirus 2 has led to a global exigency of colossal and monstrous proportions in terms of public health and economic crisis. Till date, no pharmaceutical agent is known to manage in terms of prevention and treatment of coronavirus disease 2019 (COVID-19), the disease caused by a novel virus. AIMS: The aim of the present work was to understand the underlying disease profile and dynamics that could provide relevant inputs and insight into pathophysiology and prevent further spread and evolve management strategies of COVID-19 patients from data-driven techniques. SETTINGS AND DESIGN: A retrospective observational descriptive study was conducted on 29 COVID-19 patients admitted at a premier medical institution of North India in the months of February and March 2020. METHODS: The patients were diagnosed with reverse transcription-polymerase chain reaction test. Demographic, clinical, and laboratory data were collected. RESULTS: The mean age of population was 38.8 years with male preponderance, of which two patients were residents of Italy, and others hailed from semi-arid and Western sandy arid regions of Rajasthan (urban population). The major presenting symptom complex of said COVID-19 sample population included fever (48%), cough (31%), and shortness of breath (17%). Most of the patients (83%) had no comorbidity. No clinical correlation (r) could be appreciated between the duration of test positivity and age of afflicted COVID-19 patients (r = −0.0976). CONCLUSIONS: The present evaluation of various facets of the ongoing global pandemic of COVID-19 is an attempt to portray early clinical and epidemiological parameters of the menace of COVID-19 patients admitted at SMS Medical College and Attached Hospitals, Jaipur. [ABSTRACT FROM AUTHOR]

PURPOSE: The present study was undertaken to investigate the behavioral distribution pattern and progression of coronavirus disease 2019 (COVID-19) across age and gender in the state of Rajasthan, India, inherently distinctive and native to localized part of the globe giving requisite information and paraphernalia to designate advisory board of the state to design and frame customized policy for demands of the state as per the trending pattern relative to age and sex distribution, profile of new infected cases, recovery rate, and case fatality rate. METHODS: The present ongoing study assessed patients admitted till April 22, 2020, across the state of Rajasthan, India, with reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 test. Analyses of the patients included characteristic age and gender distribution through the geographic identities of state along with the time trending pattern of newly infected patients, recovered patients, and case fatality rate. RESULTS: A total of 1888 sample patient population of RT-PCR-confirmed COVID-19 was evaluated, with the majority of sample patient population being in young adult age group with a mean age of 34.42 years. Nearly 11.65% of the patients were below 15 years of age, 34.79% were in the age range of 16–30 years, 25.90% were in the age group of 31–45 years, and 17.69% were in the age group of 46–60 years, with only 9.95% of the patient population being in the age group of above 60 years. Interestingly, 11.65% of patients with COVID-19 were in the pediatric age group. The percent of affected females (37.35%) was much less than that compared to males (62.65%), with an average sex ratio of 0.59. Across the sample patient population of 1888, 543 patients recovered fully, 25 patients died, and 1320 cases were active in the said time frame, with an average recovery rate of 28.76% and a case fatality rate of 1.32%, and the remaining 69.91% of the patient population made up the active case group. The timeline and the trending pattern of COVID-19 in the state of Rajasthan was suggestive of an increasing rise of number of new cases with antecedent mortality, though a reassuring concomitant rise in the recovery rate of patients could also be appreciated. The infective COVID-19 dictum of spread through contact could very well be appreciated in select geographic hotspots and/or zones, and 108 sample patient population was from out of Rajasthan. CONCLUSION: It was interesting to observe that majority of the resident population of the state of Rajasthan that was COVID-19 positive was in the young adult age group of 30–50 years inclusive of pediatric patients, an observation that is different from reports as documented from across the world. Male population seemed to be more prone to infection. The time frame in which the evaluation was done is suggestive of an increasing trend in the number of new cases with antecedent case fatality, though recovery was also on the rise indicative of a potential decreasing load. The geographic mapping of COVID-19 patients could be established through contact tracing. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome is defined as a state of metabolic dysregulation characterized by insulin resistance, a predisposition to Type 2 diabetes mellitus and atherosclerotic vascular disease. The changing hormonal milieu with altered estrogen and testosterone ratio is the cause of metabolic syndrome at menopausal transition. Aims and Objectives: This study was designed to determine the incidence of metabolic syndrome and its various components in premenopausal and postmenopausal women from Punjab. Materials and Methods: This study was conducted on 200 females in the age group of 45–60 years attending outpatient department over a period of 2 years in the Department of Obstetrics and Gynaecology, Bebe Nanki Mother and Child Care Centre, Government Medical College, Amritsar. A detailed history and physical examination were done and recorded on a pro forma. Biochemical assessment comprising fasting blood glucose, triglycerides, and cholesterol was done. Metabolic syndrome was assessed as per the modified NCEP ATP III criteria. Results: Twenty-nine percent women were found to have newly onset metabolic syndrome, the incidence in premenopausal group was 16%, and in postmenopausal group was 42%. Among the components, the incidence of hypertension (58%) was the highest followed by waist circumference (42%). Maximum correlation of metabolic syndrome was found with high-density lipoprotein (odds ratio - 7.250) followed by waist circumference (odds ratio - 7.111). Conclusion: The incidence of metabolic syndrome was found to be higher in postmenopausal women than in premenopausal women. Currently, the need of the hour is lifestyle modification to reduce the emergence of metabolic syndrome and cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: The 2018 postmonsoon outbreak of Zika virus infection, in a localized pocket of city of Jaipur, Rajasthan, so far the largest in India, alarmed the health authorities to optimize surveillance and measures. Hence, a community-based study to analyze the clinicodemographic profile was conducted to gain better understanding of its squeal. This study aimed to analyze the clinicodemographic profile of this new entrant viral infection. Methods: The study was designed as a community-based observational study. 1,488,870 people in vicinity of the index case were surveyed clinically from October to November 2018. A total of 1925 febrile individuals including pregnant ones in various trimesters of their pregnancy were screened for Zika infection by reverse-transcriptase-polymerase-chain-reaction (RT-PCR). Among these, 153 were RT-PCR positive and 111 cases consenting for the study were included and data collected were analyzed using SPSS 16 software. Results: The mean age of the study population was 27.51 years (95% confidence interval = 24.78–30.25), 53% of the patients were females. Out of 59 Zika-positive females, 27 (46%) were pregnant; 12 (44.4%) were in first trimester and 9 (33%) and 6 (22.2%) in second and third trimester, respectively. The incubation period ranged from 2 to 10 days, the most common symptom being low grade fever in 82%, followed by myalgia in 64.9% and arthralgia in rheumatoid distribution in 55.9%. On examination, a widely distributed blanching maculopapular rash was seen in 28.8%; nonpurulent conjunctivitis differentiating it from dengue was seen in 16.2%. Conclusions: Although Zika, a commonly prevalent virus in dengue endemic belts, yet unknown to our territory, usually causes a mild febrile illness, it can be a cause of intense apprehension to many if infection occurs in the first trimester of pregnancy. Formulating guidelines to tackle Zika pregnancy is a daunting task and needs collaboration across the globe to carry out future research and to get the knowhow. [ABSTRACT FROM AUTHOR]

Objective: The present study was conducted to evaluate the correlation of renal functions with thyroid hormone levels in patients with undialyzed chronic kidney disease (CKD). Literature shows significant alteration in thyroid hormone function tests in CKD patients who are receiving long-standing dialysis treatment. However, not much is described in those receiving conservative management without dialysis. Although CKD is associated with an increased prevalence of primary hypothyroidism, various studies on thyroid hormone status in uremic patients have reported conflicting results. Methodology: Thyroid hormone levels and biochemical markers of renal function were estimated in 30 undialyzed CKD patients and similar number of age- and sex-matched healthy controls, followed by statistical analysis and correlation. Results: Free triiodothyronine (FT3) and free thyroxine (FT4) were found to be significantly reduced (P < 0.001 for each) in undialyzed CKD patients whereas thyroid-stimulating hormone (TSH) levels showed statistically insignificant alteration in both groups. We also observed that urea and creatinine were negatively correlated whereas creatinine clearance was positively correlated with both FT3 and FT4 having high statistical (two tailed) significance with P < 0.001. Nonsignificant correlation was seen between blood urea and TSH (r = 0.236, P = 0.069), creatinine clearance, and TSH (r = 0.206, P = 0.114 Pearson's correlation coefficient). There is just significant positive correlation between the serum creatinine values and TSH (r = 0.248, P = 0.049). Conclusions: Thyroid hormones were significantly decreased in undialyzed CKD patients as compared to healthy controls. [ABSTRACT FROM AUTHOR]

Inclusion body myositis (IBM) is the most common inflammatory myopathy above the age of 50 years and three times more common in males than females. It presents as a distal more than proximal myopathy and has an indolent progressive course. Despite the latest advancements, it is challenging to diagnose this disease as it may resemble amyotrophic lateral sclerosis (ALS) clinically and polymyositis histopathologically. What sets it apart from the other myopathies is the fact that it has a very poor response to standard therapies of steroids and immunosuppressants. We present a case of a 30-year-old female patient presenting with relatively rapid onset of quadriparesis and dysphagia which was ultimately diagnosed with IBM. This case report attempts to highlight the difficulties in diagnosing this rare disease and the limited modalities of treatment. [ABSTRACT FROM AUTHOR]

With the onset of 21st century, organ donation (OD) has taken a big stride, still waiting for organ transplants is higher than its availability. Donating a life after one's death to someone you even do not know is one of the noble humanity causes. In Indian scenario, with the inception of Transplantation of Human Organs Act, 1994, multiple active initiatives were undertaken time to time for promoting OD; similarly, green corridors have also come in a big way for transfer of organs for interinstitutional transplantation. The institute undertook its first green corridor for OD in 2015 when liver was sent to one of the hospitals, and till date, 25 green corridors have been established where 27 organs have been shared with other institutes nationwide besides intrainstitute transplantations. Although this noble cause has taken its initial steps, still, innovations, and opportunities for promoting OD should be explored in a continuum for foreseeable better future. [ABSTRACT FROM AUTHOR]

The article examines the incidence of Kell blood group in the population around Amritsar in India. It notes the similarity of the incidence of Kell blood group in various blood groups. It mentions the variation of Kell blood grouping in different parts of the country. It emphasizes that Kell antigen can be used to improve the safety of blood transfusion.

The article discusses a study related to the compliance rate and improvement measures for hand hygiene (HH) in health care facilities. It informs about the launch of the Global Patient Safety Challenge by the World Health Organization. It also mentions the requirement of robust surveillance system, infection control team and proper staff for patient care services in health care organizations.