Introduction: If good personal hygiene since childhood is not maintained, it will leads to various contagious diseases like gastroenteritis, skin infections etc. So present study was done to assess knowledge and practice regarding personal hygiene in school going children. Methodology: this cross sectional study was conducted on 1008 students of 6 th to 12 th class from government schools of Bikaner. A semi-structured Performa was used. Result: More than 90% students had knowledge about body, clothes and teeth hygiene, 46% about use of toilet paper and 29.8% about sanitary pad. More than 90% bath, brush teeth every day, hand wash before meal and after using toilet. Less than 70% hand wash after handling animal, cutting nails. Major source of knowledge in students was schools (71%). Conclusion:A good knowledge and practice was found regarding certain points but still more awareness and promotion are necessary for better personal hygiene in students.
Background: Laparoscopic cholecystectomy (LC) can be the easiest or the most difficult laparoscopic operation. Conversion to open surgery has been a traditional marker of difficult LC. Recent studies have shown that C-reactive protein (CRP) may be helpful to surgeon in knowing the pathological condition of gall bladder before removal. Aim of this study was to evaluate the role of CRP as a predictor of difficult LC or its conversion.Methods: This study was done from 1 march 2016 to may 2017 in department of general surgery, SMS hospital Jaipur, under single unit. All patients with cholelithiasis admitted in single unit of SMS hospital undergoing LC were included in this study. Exclusion criteria were high BMI (>35), proven congenital anomaly of gall bladder, previous abdominal surgery, any conditions increasing CRP and immunocompromised patients. CRP was done for each patient.Results: Mean age of our 148 patients was 50.41 years. Female to male ratio was 4.28:1. Mean CRP was 22.2±18.2 mg/dl for simple cholecystectomy, 46.5±32.0 mg/dl for difficult cholecystectomy and 83.6±22.4 mg/dl for laparoscopic converted to open cholecystectomy, which was statistically significant (p value 0.0002).Conclusions: CRP is a potent predictor of difficult laparoscopic cholecystectomy and its conversion preoperatively. Patients with preoperatively high CRP have higher chance of complication intraoperative and high chances of conversion to open.
Objective: Pancreas is a less commonly injured organ in blunt abdominal trauma. This study aimed to analyze the management and outcomes of patients in whom the pancreatic injury was missed during the initial evaluation of blunt abdominal trauma. Material and Methods: We retrospectively (2009-2019) analyzed the details and outcome of patients who underwent conservative management of blunt abdominal trauma, where the diagnosis of pancreatic injury was missed for at least 72 hours following trauma. Results: A total of 31 patients with missed pancreatic injury were identified. All patients were hemodynamically stable following trauma and most (21) were initially assessed only by an ultrasound. A delayed diagnosis of pancreatic injury was made at a mean of 28 (4 to 60) days after trauma when patients developed abdominal pain (31), distension (18), fever (10) or vomiting (8). On repeat imaging, 18 (58.1%) patients had high grade pancreatic injuries including complete transection or pancreatic duct injury. Seven (22.5%) patients were managed conservatively, seventeen (54.8%) underwent percutaneous drainage of intra-abdominal collections, seven (22.5%) underwent endoscopic or surgical drainage procedure for symptomatic pseudocyst. Eleven (35.4%) patients needed readmissions to manage recurrent pancreatitis, intra-abdominal abscess and pancreatic fistula. Three patients required pancreatic duct stenting for pancreatic fistula. There was no mortality. Conclusion: Pancreatic injury may be missed in patients who remain hemodynamically stable with minimal clinical symptoms after abdominal trauma, especially if screened only by an ultrasound. In our series, there was significant morbidity of missed pancreatic injury.
Background: Adolescents constituting 21% of India’s population. Most mental disorders begin before age 14, though they are often first detected later in life. Detecting these disorders and individual prone to these disorders at earlier ages can facilitate better treatment. With this in mind the present study was planned to find out the prevalence and pattern of mental health problem and their association with socio-demographic factors (age, gender, religion and socio-economic status) in school going adolescents in Jaipur.Methods: A cross-sectional study was conducted on 994 school going adolescents (11-17 years) studying in 6th to 12th class of Jaipur city, Rajasthan. The simple random sampling and self reported version of Strength & Difficulty questionnaire (SDQ) were used to assess mental health. Chi-square was used to test significance.Results: The 8.35% school going adolescents had abnormal SDQ score indicating probable mental disorders. The borderline and normal adolescents on total difficulty score were 14.19%, 77.46% respectively. Conduct Problem was the most prevalent (12%), followed by emotional (10%), peer (7%), hyperactivity (6%) and prosocial problem (5%). Impact of total difficulty was abnormal in 13.78% adolescents. The age and SES were found significantly associated with mental health problems (p<0.05). The mental health was not associated with gender, religion and school type.Conclusions: The proportion of borderline and abnormal adolescents was more than one fifth on total difficulty score that need further evaluation and appropriate counselling/treatment by psychiatrist.
Background: Tetanus is an acute neurological fatal disorder caused by anaerobic spore forming bacillus Clostridium tetani, which produced an exotoxin (Tetanospasmin) in a wound. Purpose of this study was to find out the clinico-epidemiological factors of tetanus and how we can modify or minimize the outcome of this disease.Methods: This prospective, observational study was conducted in isolation ward in department of general surgery, SMS hospital Jaipur (Rajasthan) from 1 March 2016 to October 2017. Two hundred patients with clinical diagnosis of tetanus, who were admitted in single unit of SMS hospital, recruited in this study. Patients with age less than 1 yr were excluded. After admission, patient’s detailed history and thorough clinical examination done. The day to day progress of the cases was followed till the time of their discharge from the hospital. Outcome variables were age, gender, geographical area, causes of tetanus and site of injury, precipitating factors, role of baclofen, morbidity, cured and mortality.Results: In this study, mean age of patients were 17 years and male to female ratio was 2.44:1. Most of patients were from rural backgrounds with rural to urban ratio of 6.14:1. Overall mortality in present study was 16.5%. The severity of disease directly related with mortality. The mortality for mild, moderate and severe tetanus was 0%, 1.9% and 68.1% respectively.Conclusions: Though tetanus is a vaccine preventable illness, its prevalence is high in our country. The incidence of tetanus can be reduced by: strengthening of primary immunization programme; proper wound management and giving prophylactic tetanus immune globulins along with tetanus vaccine.
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