Clinicoetiological Pattern and Outcome of Neonates Requiring Mechanical Ventilation: Study in a Tertiary Care Centre.

The clinical and etiological pattern of ventilated newborns, their outcome in relation to morbidity and mortality was studied with 50 ventilated newborns, including outborns. M:f ratio was 2.1:1. The most common gestational age 28-36 weeks (60%) and mostly were appropriate for gestational age (66%). Survival rate 40% (20/50) being directly proportional to the gestational age and intrauterine growth pattern (P < 0.01). Babies by LSCS Lower Segment Cessarian Section survived more than born by normal vaginal delivery (46.7% vs. 37.1%). More outborn survival could be related to their advanced gestational age on presentation. The initial assessment of APGAR score of >7 had a better outcome (56.3%; P < 0.03). The most common indication of ventilation was hyaline membrane disease (19/50) but the survival rate best in babies with meconium aspiration syndrome (54.5%). The most prevalent complication was sepsis (survival rate 60%) while conditions such as shock, intraventricular hemorrhage, disseminated intravascular coagulation, air leak syndrome, and pulmonary hemorrhage had 100% mortality. Thus, the outcome as survival is constrained by many factors; newborn's profile, conditions at birth, and postnatal resuscitation.

Prevalence of autism spectrum disorders among children (1-10 years of age) - findings of a mid-term report from Northwest India.

BACKGROUND: India is the second most populous country of the world. A large portion of the population of this country is below 20 years of age but still there is a paucity of information about the prevalence and incidence of many developmental disorders. This study was planned to estimate the prevalence of autism spectrum disorders (ASDs) in the selected areas (tribal, rural, and urban) of a northern state of India, Himachal Pradesh. METHODS: A cross-sectional two-phase study was conducted covering all the children in the range of 1-10 years of age. Phase one included screening of all the children in the age group of 1-10 years, with the help of an indigenous assessment tool for autism. The sociodemographic profile of the participants was also recorded during phase one. Phase two involved the clinical evaluation of individuals who were suspected of autism on screening. RESULTS: The results show a prevalence rate of 0.9/1000. The highest prevalence rate was observed in the rural area. CONCLUSIONS: Socioeconomic status (SES) may be one of the fundamental indicators for ASDs in India.

Contribution of medical colleges to tuberculosis control in India under the Revised National Tuberculosis Control Programme (RNTCP): lessons learnt & challenges ahead.

Medical college faculty, who are academicians are seldom directly involved in the implementation of national public health programmes. More than a decade ago for the first time in the global history of tuberculosis (TB) control, medical colleges of India were involved in the Revised National TB Control Programme (RNTCP) of Government of India (GOI). This report documents the unique and extraordinary course of events that led to the involvement of medical colleges in the RNTCP of GOI. It also reports the contributions made by the medical colleges to TB control in India. For more than a decade, medical colleges have been providing diagnostic services (Designated Microscopy Centres), treatment [Directly Observed Treatment (DOT) Centres] referral for treatment, recording and reporting data, carrying out advocacy for RNTCP and conducting operational research relevant to RNTCP. Medical colleges are contributing to diagnosis and treatment of human immunodeficiency virus (HIV)-TB co-infection and development of laboratory infrastructure for early diagnosis of multidrug-resistant and/or extensively drug-resistant TB (M/XDR-TB) and DOTS-Plus sites for treatment of MDR-TB cases. Overall, at a national level, medical colleges have contributed to 25 per cent of TB suspects referred for diagnosis; 23 per cent of 'new smear-positives' diagnosed; 7 per cent of DOT provision within medical college; and 86 per cent treatment success rate among new smear-positive patients. As the Programme widens its scope, future challenges include sustenance of this contribution and facilitating universal access to quality TB care; greater involvement in operational research relevant to the Programme needs; and better co-ordination mechanisms between district, state, zonal and national level to encourage their involvement.

Short-term effects of multimodal stimulation on neuromotor behaviour and neonatal pain among hospitalized preterm infants: A feasibility, non-blinded randomized controlled trial.

BACKGROUND: Preterm infant experiences neuromotor disturbances and neonatal pain during NICU stay. Optimal brain development and pain tolerance require both sensory and motor experiences. We aimed to explore the effect of multimodal stimulation (MMS) including multi-sensory and movement therapy on neuromotor behaviour and neonatal pain among hospitalized preterm infants. METHODS: 32 recruited preterm infants [gestational age (GA): 28 to 36 weeks] by convenience sampling technique for pre-test-post-test control group, single-center randomized controlled study were randomly allocated into two groups, MMS group, and control group. MMS group received the interventions for 5 days period, totalling five sessions with 30 minutes/session. Infant Neurological International Battery (INFANIB), Neonatal Infant Pain Scale (NIPS), weight, length, and Occipitofrontal circumference (OFC) were recorded at baseline and 6th day to analyze the changes observed neuromotor behaviour, neonatal pain, and changes in the anthropometric parameters respectively. RESULTS: GA, weight, length and OFC of preterm infants recruited were, 34.4±2 weeks, 2.11±0.48 kg, 45±3.8 cm and 32.3±1.7 cm respectively. INFANIB and NIPS change scores in MMS group were [4 (2, 6); p = 0.001] and NIPS scores [2 (2,3); p < 0.001] respectively when compared to INFANIB [- 4 (- 6, - 2); p = 0.001] and NIPS scores [1 (- 1,1); p = 0.778] in control group. Significant difference p < 0.001 in INFANIB and NIPS scores while non-significant difference in weight (p = 0.166), length (p = 0.443) and OFC (p = 0.413) were observed between the groups. CONCLUSION: Administration of MMS has a positive clinically significant impact on neuromotor behaviour and neonatal pain on preterm infants.

Neonatal aquatic physiotherapy in neonatal intensive care units: A scoping review.

BACKGROUND: Therapeutic benefits of neonates undergoing neonatal aquatic physiotherapy (NAPT) are evident from the available literature. However complied report on NAPT is not yet available. Hence, we have mapped the available interventions to treat neonates admitted in neonatal intensive care units (NICUs) using NAPT in a scoping review. METHOD: Six databases which includes, MEDLINE/PubMed, SCOPUS, PEDro, CINHAL, EBSCO and Cochrane were searched with predefined keywords specific to or related to NAPT interventions from 1983 to August, 2020 for the full-text English language articles. RESULTS: A total of 6163 relevant articles were identified from the search process. After duplicates were removed, 6146 articles were screened for inclusion, leaving 809 articles assessed for eligibility criteria. Six (n = 6) articles met all criteria and were included in the final qualitative synthesis. CONCLUSION: NAPT may be an effective intervention to normalize the muscle tone, to promote active movements, postural organization, improves sleep pattern and quality, promotes the thermal and cardiorespiratory adaptations, and moreover reduces neonatal pain among the neonates admitted in NICUs.

Association of risk factors with musculoskeletal disorders in manual-working farmers.

The current study is aimed at recognizing the risk factors for major work-related issues (ie, musculoskeletal disorders [MSDs]) among 138 manual-working farmers. Data were collected using modified Standardized Nordic Questionnaire and the Rapid Upper Limb Assessment score sheet. Different factors influencing MSDs were detected using logistic regression methods. The highest occurrence rate for MSDs was observed in the lower back (71.4%), followed by fingers (62.1%), shoulders (56.4%), and hands/wrists (55%). Factors such as age, gender, daily working hours, hand dominance, perceived fatigue, and work experience were found to be associated with MSDs in one or more upper body regions. The outcome of multinomial regression showed that gender is the most influencing factor for MSDs in all upper body regions except the shoulders. The outcomes of study indicate high occurrence of MSDs among manual-working farmers and highlight the significance of individual and work-related factors.

Electrocardiographic manifestations of healthy residents of a tribal Himalayan village.

Electrocardiograms of 984 healthy subjects residing in village Kalpa at the height of 9000 feet above sea level were studied. Right ventricular hypertrophy (RVH) was observed in 9 (0.914%) subjects. Electrocardiographic evidence of ischaemic heart disease was found in 6 (0.609%) subjects.

Problems and prospects of a traditional source of potable water in hilly terrains.

During epidemic investigation, water sources were tested for quality for drinking purpose. Out of 30 khatris tested, water of 86.7% khatris was fit for human consumption and fecal coliform was not found in any of them. Modification of these khatris was stressed by respondents.

Capacity building of AYUSH practitioners to study the feasibility of their involvement in non-communicable disease prevention and control.

BACKGROUND: Sharing of public health knowledge and skills by professionals in allopathic system of medicine with Ayurveda, Yoga, and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) professionals in India has always been considered as part of integrating the health system in India. But till date, a curriculum has not been framed for follow-up. MATERIALS AND METHODS: A training course was developed for AYUSH professionals in India on the public health principles for the prevention and control of non-communicable diseases (NCDs). Three course chairs interacted with international and national public health and AYUSH experts, and the curriculum for a 3-month course was developed. RESULTS: The curriculum comprised interactive lectures, problem-based exercise, field visits, and research protocol development. A total of four participants, nominated by the World Health Organization, India, were trained during the course, with significant (P = 0.00) improvement in knowledge from 53.2 to 80.0 points. CONCLUSION: A novel and feasible public health course for complementary and alternative medicine professionals on the public health principles for NCDs' prevention and control is needed to bridge the demand gap for public health professionals in India.

Scoring the medical outcomes among HIV / AIDS patients attending antiretroviral therapy center at Zonal Hospital, Hamirpur, using Patient Satisfaction Questionnaire (PSQ-18).

AIM: To study level of satisfaction among patients attending ART centre using Patient Satisfaction Questionnaire (PSQ - 18). MATERIALS AND METHODS: A cross-sectional interview based technique was used to study the level of satisfaction. RESULTS: A total of 59 patients attending ART centre were included in the study. The mean score for general satisfaction was 3.22 (SD 0.86), for technical quality 3.03 (SD 0.92), for the interpersonal manner 3.25 (SD 0.93), for communication (SD 0.90), for financial aspects was 2.38 (SD 1.00) and for time spent during the visit, the mean score was 2.97 (SD 0.98) INTERPRETATION: Patient satisfaction is the key in planning and formulating guidelines for treatment and care.

Sciatic nerve division: a cadaver study in the Indian population and review of the literature.

INTRODUCTION: The sciatic nerve is the largest nerve, with a long course in the inferior extremity. Its division into the tibial and common peroneal nerves can occur at any level from the sacral plexus to the inferior part of the popliteal space. These anatomical variations may contribute to clinical conditions such as piriformis syndrome, sciatica and coccygodynia. METHODS: This study was performed on cadavers in order to study the level of sciatic nerve division. The inferior extremities of 43 cadavers were classified into six groups depending on the level of sciatic nerve division in the gluteal region, the upper, middle and lower parts of the back of the thigh, and the popliteal fossa. RESULTS: The highest incidence of sciatic nerve division (40.7 percent) was observed in the lower part of the posterior compartment of the thigh. In 34.9 percent of the specimens, the sciatic nerve was divided into tibial and common peroneal nerves in the popliteal fossa. 16.3 percent of extremities showed sciatic nerve division proximal to its entrance in the gluteal region. CONCLUSION: In sciatic nerve neuropathies, the extent of neurological deficits depends on the level of sciatic nerve division. Sciatic nerve division into tibial and common peroneal components at a higher level can result in the involvement of only one out of the two divisions from sciatic neuropathy. It can also result in a failure of the sciatic nerve block while performing popliteal block anaesthesia.

Prevalence of reproductive tract infections amongst ever married women and sociocultural factors associated with it.

A community-based study was carried out to assess the prevalence of reproductive tract infections (RTIs) among ever married rural women aged 15 -45 years at village Naila during 2002. Six hundred houses were surveyed and all the eligible women residing in these houses were interviewed by MPWs and Interns and were offered medical examinations at rural health training centre, Naila. At least one symptom related to RTIs was found in 471(55%) out of 859 women. Only 50% (432/859) women gave consent for their gynaecological and microbiological examinations. Out of 432 women examined 61% (263/432) had at least one type of RTIs. Out of 263 cases, 43% had cervicitis, 26% had bacterial vaginitis, 14% had fungal infection, 8% had trichomonas vaginitis, 22% had pelvic inflammatory disease and 19% had cervical erosion. Prevalence of RTI was significantly associated with age, personal hygiene, material used for menstrual blood, gravida status, type of attendance at child birth, invasive contraceptives, gynaecological surgery but caste, literacy status and place of deliveries were not significantly associated with RTI status in the present study.

Le Fort I down-fracture of the maxilla: application to benign antral neoplasm.

Benign neoplasms of the maxillo-facial region require different treatment than do malignant lesions. Conservation of adjacent tissues is vital in order to optimize postoperative function and esthetics. The Le Fort I down-fracture technique is a historically proven approach for resecting benign neoplasms involving the nasal and para-nasal cavities. The Le Fort I, as practised today, is transoral and placed superior to the dento-alveolar processes of the maxilla. Surgical access, therefore, need not result in a skin scar nor loss of dental structures. Postoperative recovery to full function is rapid. The elegance and versatility of the Le Fort I down-fracture technique is discussed with reference to the report of a large, intra-antral benign odontogenic neoplasm.