Objectives: The study aimed to assess the functionality of labour rooms by evaluating the labour room infrastructure with reference to the standard guidelines, the status of the availability of human resources, the availability of essential equipment and consumables in the labour room and by documenting the knowledge of the healthcare provider in terms of labour room practices. The study also explored the facility parameters associated with its delivery load taking the facility as a unit of analysis. Design: A cross-sectional analytical study. Setting: India has realised the importance of improving the quality of care in public health facilities, and steps are being taken to make healthcare more responsive to women's needs. With an increase in the proportion of institutional deliveries in India, the outcome of the delivery process can be improved by optimising the health facility components. Participants: The study was conducted in 52 health facilities and healthcare providers involved in the delivery process in the selected facilities. Results: The infrastructure of the facilities was found to be the best for medical college followed by district hospitals, Community Health Centres (CHCs), Primary Health Centres (PHCs) and subcentres. Similar findings were observed in terms of the availability of equipment and consumables. Lack of healthcare providers was observed as only 20% of the posts for health personnel were fulfilled in CHCs followed by PHCs, subcentres and district hospitals where 43, 50 and 79% of the available vacancies were fulfilled. The level of knowledge of healthcare providers in terms of partograph, active management of the third stage of labour and post-partum haemorrhage ranged as per their designation. The specialists were the most knowledgeable while the Auxiliary Nurse Midwife (AMNs) were the least. All the components of structural capacity, i.e. infrastructure ( r 2 = 0.377, P value < 0.001), equipment and consumable ( r 2 = 0.606, P value < 0.001) and knowledge of healthcare providers ( r 2 = 0.456, P value < 0.001) along with the overall facility score were positively correlated with the average delivery load of the health facility. The results from multivariate linear regression depict significant relation between the delivery load and availability of equipment and consumables ( t = 4.015, P < 0.01) and with the knowledge of healthcare providers ( t = 2.129, P = 0.039). Conclusions: The higher facilities were better equipped to provide delivery and newborn care. A higher delivery load was found at high-level facilities wh...
A BSTRACT Background: COVID-19 vaccines have been rolled out recently in several parts of the world. Although the protective efficacy is frequently discussed, little is known about the factors associated with COVID-19 vaccine adverse effects. The study was conducted with the aim to evaluate the occurrence of adverse events following immunization (AEFI) with two doses of covishield and covaxin and to assess factors associated with these adverse effects. Methods: A longitudinal study was conducted for a period of three months in the adults above 18 years of age attending rural health training center (RHTC) either to receive their first or second dose of covishield or covaxin. After vaccination, the participants were observed at the health facility for 30 min for any AEFI and also followed up telephonically on seventh day from vaccination. Data was collected on predesigned and pretested questionnaire and appropriate statistical tests were applied. Results: Out of 532 participants, 250 (47%) came for their first dose while 282 (53%) came for second dose. In both the groups maximum participation was seen by males and those belonging to age group 18–30 years. Majority of the participants reported local tenderness (39.3%) after first dose of covaxin and fever (30.5%) after first dose of covishield. Mainly significant association was observed after vaccination in participants with comorbidities. Conclusion: The short-term adverse events with both the vaccines were observed, but these were mild and short lived. In this context, our study becomes more relevant in disseminating short-term safety data post vaccination. This will help individuals in their decision to accept vaccination.
Aim. The current study was aimed to analyze the etiology and the clinical spectrum of acute symptomatic seizures (ASS) and the predictors of in- hospital mortality in the elderly population. Methods. We evaluated ninety-four elderly (≥60 years of age) hospitalized patients with ASS for clinical profile, aetiologies and predictors of in-hospital mortality. Results. Mean age of onset of ASS was 67.63 ± 11.48 years. Main seizure type was focal seizure in 62 (59.7%) cases followed by tonic-clonic seizures in 30 (31.9%) cases. Most common aetiologies in ASS were stroke in 61.7% followed by infective cause in 30.9% of cases. In-hospital mortality in the ASS in the elderly was 21 (22.3%) in our series and the stroke was the most common cause of mortality. Conclusion. Stroke was the most common etiology of ASS in the elderly and was also related with mortality. It is necessary for us to analysis the causes of ASS in the elderly, in order to reduce the in-hospital mortality.
Nipah Virus is a recently emerging zoonotic virus with disease causing potential in both animals and humans. Nipah virus belongs to the family of paramyxovirida, genus Henipavirus along with Hendra virus. (1) The knowledge of human infection with Henipavirus was limited to a very small number of cases infected with Hendra virus in Australia during 1994-1999 which was responsible for deaths of two humans and seventeen horses. (2) Nipah virus was first identified and isolated in 1999 in Malaysia during an outbreak of febrile illness among pig farmers and people who were in close contacts with pigs. (3) In 2001, Nipah virus was identified as the causative agent of outbreak in Bangladesh. Since then number of outbreaks has been reported in various districts of Bangladesh. (4) In India, a total of three outbreaks of Nipah have been reported, latest being on 19th May 2018, from Kozhikode district of Kerala. (5) With a fatality rate of 58%, Nipah virus is primarily seen to cause encephalitis and severe respiratory distress. Despite of the severe pathogenicity and high pandemic potential there is no specific treatment for Nipah virus encephalitis except for supportive and symptomatic treatment.
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