Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach / 예방의학회지

Objectives@#Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics. @*Methods@#For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis. @*Results@#A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients’ parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists. @*Conclusions@#Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

Comparison of clinical outcomes of Eyecryl toric and Alcon toric intra-ocular lenses – A real world study

Purpose: To compare the visual outcomes and residual astigmatism following implantation of Eyecryl toric versus Alcon AcrySof IQ toric intra?ocular lenses (IOLs). Methods: This retrospective, observational study included 143 eyes of 141 patients who underwent phaco?emulsification, followed by implantation of Eyecryl toric IOL (n = 83 eyes) or Alcon toric IOL (n = 60 eyes) in an eye hospital in South India from 2018 to 2021. At 1 month post?op, the uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), and residual astigmatism of the toric IOL were compared and analyzed. Results: The mean pre?op corneal astigmatism was 2.02 ± 0.81 D and 1.70 ± 0.68 D in the Alcon and Eyecryl groups, respectively (P = 0.005). The mean post?op corneal astigmatism at 1 month was 0.50 ± 0.51 D and 0.36 ± 0.42 D in the Alcon and Eyecryl groups, respectively, with no statistically significant difference between them (P = 0.87). The mean post?op UCVA in logarithm of minimum angle of resolution (logMAR) at 1 month was similar between the groups at 0.17 ± 0.18 and 0.17 ± 0.16 in the Alcon and Eyecryl groups, respectively (P = 0.98). The mean post?op BCVA in logMAR at 1 month was 0.06 ± 0.09 and 0.03 ± 0.10 in the Alcon and Eyecryl groups, respectively (P = 0.02). Conclusion: Both Eyecryl toric and Alcon AcrySof IQ toric IOLs showed comparable post?operative outcomes in terms of UCVA and residual astigmatism. The post?op BCVA was clinically similar between groups but statistically better in the Eyecryl toric group

Management of anxiety using eye movement desensitization and reprocessing therapy in children undergoing extraction: a randomized controlled pilot study

Background@#Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy. @*Methods@#Children in the age range of 8–12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2;receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction. @*Results@#Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student’s t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. @*Conclusion@#EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

TREATING OBSESSIVE COMPULSIVE DISORDER WITH ACCEPTANCE AND COMMITMENT THERAPY AND EXPOSURE AND RESPONSE PREVENTION– A CLINICAL CASE ILLUSTRATION

Obsessive Compulsive Disorder (OCD) is ranked the top 10 of the most handicapping illnesses by lost income and decreased quality of life. Hence the need to overcome OCD is imminent. With the present case of OCD, Acceptance and Commitment Therapy (ACT) and Exposure Prevention Response (ERP) were used for treating OCD. Assessment was done using Yale Brown Obsessive Compulsive Scale and Weiss Functional Impairment Rating Scale – Self report. Results show that OCD reduced signi?cantly after the treatment.

A COMPARATIVE STUDY OF COPING STRATEGIES IN SPOUSES OF NORMAL SUBJECTS AND PATIENTS DIAGNOSED WITH ALCOHOL DEPENDENCE SYNDROME

Introduction: Alcohol dependence syndrome is a very common condition affecting the general population. Alcohol abuse can result in novelty seeking and risk taking behaviour resulting in violence and road traffic accidents. Long duration abuse can cause several psychiatric disorders like anxiety, depression, and family disharmony. These problems are much more common in countries like India. In this single stage cross-sectional case control Methodology and Results: study, the degree of psychological well-being was grossly affected in spouses of patients with alcohol dependence in comparison to spouses of normal subjects. The overall mean (SD) of desirable coping strategies was 33.08 (7.7) in the study group and 68.0 (2.0) in the control group. The overall mean (SD) of undesirable coping strategies was 28.8 (4.2) in the study group and 5.2 (1.6) in the control group. In the study group, higher means were obtained by greater use of undesirable coping strategies in comparison to that in control group. Further analysis into the domains showed significant difference (P-value 0.001) between the study and control groups in all domains except substance use. The spouses of the Conclusion: study group showed higher usage of maladaptive coping strategies to handle their stress

Visual outcomes of toxic optic neuropathy secondary to Ethambutol: A retrospective observational study from India, an endemic country

Purpose: Ethambutol (EMB) is one of the first?line drugs used for treating tuberculosis. Vision loss due to optic nerve toxicity is a well?known potential side effect of the drug. Our aim was to evaluate the clinical features and visual outcomes of patients with EMB optic neuropathy (EON). Methods: A retrospective, observational, single?center study of all patients who were diagnosed to have EON during January 2017–December 2019 was done. All these patients were screened in the Department of Neuro?ophthalmology at a referral tertiary eye care institution in India. Clinical features, visual outcomes, and neuroimaging findings of these patients were analyzed. Results: Two hundred and fifty?six eyes of 128 patients were included. Of these, 73 were male and 55 were female. Mean age was 50.55 ± 15 years. Mean visual acuity at presentation was 1.12 ± 0.45 logarithm of the minimum angle of resolution (logMAR). One hundred and forty three eyes had normal optic disk on presentation, 111 had disk pallor, and two eyes had disk edema. The most common field defect was central/paracentral scotoma (26.2%) followed by temporal defects (24.6%). Magnetic resonance imaging (MRI) brain and orbit showed optic nerve signals in 19.6% and chiasmal signals in 5.2%. At the final follow?up, a ?2?line vision improvement was noted in 161 eyes (62.9%), which was statistically significant. Conclusion: Multiple prognostic factors were analyzed to predict the visual recovery of EON. We observed that patients presenting with visual acuity worse than 6/60 had poor visual outcome and long duration of follow?up showed better visual recovery, proving the possibility of a gradual recovery pattern of EON. Interestingly, we found in our study that the chances of favorable visual outcome were directly proportionate to early diagnosis and cessation of EMB.

ANALYSIS OF RISK FACTORS OF PREECLAMPSIA AND ECLAMPSIA AND ITS EFFECTS ON MATERNAL AND FETAL OUTCOME AS PER GESTOSIS SCORE

Objectives: Observation and analysis of the risk factors associated with preeclampsia and eclampsia and its effect on maternal and fetal outcome. It is a prospective study where 500 diagnosed Methods: cases of preeclampsia and eclampsia were recruited after taking informed consent. Data collected on the basis of detailed history and clinical evaluation. The maximum number of preeclampsia and eclampsia in the present series occurred Result: between the age group 21 to 25 years (46%). Majority of cases (71.4%) in our study presented between 35.1 to 40 weeks of gestational age. 24.4% cases had BMI in range of 25-29.9. 51.4% women were primipara and 53.2% cases were unbooked. Majority of the cases (45.2%) belonged to the upper lower socio-economic class. Out of 500 cases, 23.2% had anaemia, followed by hypothyroidism in 14.8% cases, GDM in 3.8% cases, obesity 2.8% cases, chronic hypertension in 2.2% cases, diabetes mellitus in 2% cases, and PCOD in 0.4 % cases. Risk factors found in our study that affected maternal and perinatal outcome severely were: primiparity, unbooked status, lower middle class III and upper lower class IV, BMI>24.9, gestational age < 34 weeks, anaemia, hypothyroidism and chronic hypertension and gestational diabetes mellitus. Our study reveals Conclusion: that if patients present with multiple risk factors (three and more), maternal morbidity and mortality increased signi?cantly.

Perceived barriers to implementing occupation-based intervention / Percepção de barreiras para implementar intervenções baseadas em ocupação

Abstract Introduction Occupation-based intervention (OBI) is defined as an intervention using a clients' occupation and purposeful activities as a treatment medium to achieve the client's goals. Several barriers to practising OBI have been reported in previous studies. However, limited research has been done to identify these perceived barriers to applying OBI in Malaysia's various occupational therapy practice areas. Objective This study aimed to identify perceived barriers to applying OBI in Malaysia's three main occupational therapy practice areas including physical, psychiatry and paediatric. Method A cross-sectional study design was employed, and participants were recruited using a purposive sampling strategy. Data was collected using an online survey from a Delphi study. Results Two hundred ninety-eight Malaysian occupational therapists aged between 22 and 56 years old participated in this study. The study identified several perceived barriers from the client factors, the contextual factors, occupation as treatment modalities and logistical issues. A statistically significant difference was found in the perceived barriers of applying OBI between different areas of occupational therapy practice (p=.013), working experience (p=.003), and position of occupational therapists (p=.001). Conclusion This study suggests that perceived barriers to applying OBI were influenced by the area of practice, working experience and position of the occupational therapists. The results highlight the need to identify potential solutions to applying OBI through research and education.

Resumo Introdução Intervenção baseada na ocupação (OBI) é definida como uma intervenção usando a ocupação dos sujeitos e as atividades propostas como meio de tratamento, para atingir os objetivos dos sujeitos. Várias barreiras com relação à prática de OBI foram relatadas em estudos anteriores. No entanto, pesquisas limitadas foram feitas para identificar essas barreiras percebidas para a aplicação do OBI nas várias áreas de prática de terapia ocupacional na Malásia. Objetivo Este estudo teve como objetivo identificar as barreiras percebidas para a aplicação do OBI nas três principais áreas de prática de terapia ocupacional na Malásia, incluindo áreas físicas, psiquiátricas e pediátricas. Método Um desenho de estudo transversal foi empregado e os participantes foram recrutados usando uma estratégia de amostragem intencional. Os dados foram coletados por meio de uma pesquisa online de um estudo Delphi. Resultados Duzentos e noventa e oito terapeutas ocupacionais malaios com idades entre 22 e 56 anos participaram deste estudo. O estudo identificou várias barreiras percebidas nos fatores contextuais das pessoas, na ocupação como modalidades de tratamento e nas questões logística. Uma diferença estatisticamente significativa foi encontrada nas barreiras percebidas da aplicação do OBI entre diferentes áreas da prática da terapia ocupacional (p = 0,013), experiência de trabalho (p = 0,003) e posição dos terapeutas ocupacionais (p = 0,001). Conclusão Este estudo sugere que as barreiras percebidas para a aplicação do OBI foram influenciadas pela área de prática, experiência de trabalho e posição dos terapeutas ocupacionais. Os resultados destacam a necessidade de identificar soluções potenciais para a aplicação do OBI por meio de pesquisa e educação.

Current realities of dental graduates about dental profession: Cross- sectional study future prospects of dental graduates

Purpose: Dentistry is specialized branch for head and neck region. In this field exponential growth in technology has taken place in the last few decades. At the same time dental graduates also increased. As the patient to doctor ratio has increased, it helped in offering services to the needy, but on the flip side, many qualified dentists are shifting careers due to multiple reasons. This study was conducted to know the awareness of dental graduates on their future prospects in pursuing the dental career. Materials and methods: A cross-sectional questionnaire survey was conducted among junior residents who attended the dental conference using a structured questionnaire. Questions are prepared in a customized form which elicits, knowledge and awareness of dental graduates on their future prospects among junior residents. Results: A total of 210 dental graduates/ junior residents participated in the study. Among them, nearly half of the sample, i.e. 42.4% of dental graduates are satisfied only 50% in pursuing dentistry. Most of the participants, i.e., 63.8% are willing to change the profession, while remaining one-third of the sample, i.e., 36.7% are willing to work in government sector. Only a few graduates, i.e. 22.4% of them were interested in teaching or academics. Conclusion: Even though most of the dental graduates were happy in pursuing dentistry, but most of them were willing to change the career option because of a stressful job timing with no expected fruitful returns in terms of income. This problem is also escalating because of fewer job opportunities.

To Assess the Knowledge of Dentists Regarding Dentinal Hypersensitivity in a Tertiary Dental Care Hospital in Bangalore City - A Cross Sectional Survey

Dental pain is most commonly associated with the carious destruction leading to inflammation of the pulp or can also be pain present post operatively; however, much of the dental pain can be attributed to dentinal hypersensitivity (DH). The prevalence of DH is high enough (72.5 % to 98 %) to warrant the development of effective treatment. Surveys among dental professionals worldwide suggest that many lack adequate knowledge about this condition and its management. This study aims to assess the knowledge and awareness of postgraduates and faculty regarding dentinal hypersensitivity in a tertiary dental care hospital in Bangalore. METHODSA descriptive cross-sectional survey was carried out among the staff and post graduate students at Rajarajeswari Dental College & Hospital, Bangalore during October 2019. Ethical clearance was obtained from the Institutional Ethical committee. All the staff and post graduate students who were present on the day of study were included in the study. Informed consent was obtained from all the study participants before the study and participation was entirely voluntary. RESULTSMajority of the participants routinely checked for the signs of DH (F - 77.2 % PG - 77 %) and considered DH as a serious problem (F - 87.5 % PG - 87 %). Participants also thought that DH has to be treated with an interdisciplinary approach (F - 75 % PG - 67.7 %). CONCLUSIONSThe study concludes that even though the knowledge and awareness of Dentinal Hypersensitivity was good, there existed uncertainty concerning diagnosis and management of the same.

Burden of anemia and its associated factors among pregnant women of Vindhya region: prospective observational study

Background: Anemia is major public health problem. It is especially prevalent in women of reproductive age, particularly during pregnancy. It affects both developed and developing countries. According to the National Family Health Survey, anemia is prevalent in approximately 53.1% of non-pregnant and 50.1% of pregnant women. Objective of this study was to study the prevalence of anemia in pregnant women of Vindhya region and also various degree of anemia and factors associated.Methods: All pregnant women attending the outdoor and indoor of the obstetrics and gynecology department of, GMH. Rewa, taken for calculation of prevalence of anaemia and among them 510 pregnant women were selected who were satisfying inclusion and exclusion criteria for studying association factors. Study period was 1 year. Haemoglobin estimation done by sahlis haemoglobinometer.Results: Prevalence of anaemia figures 81%, Out of them, 38.05% mild, 33.26% moderate and 7.80% of women were severely anemic. Maximum number of women were housewives 71.1%. Anaemia was found more commonly among those who are either taking iron prophylaxis irregularly or not taking. High prevalence was noted among those pregnant women who had <4 antenatal visits i.e., 54.51%.Conclusions: Considering the high prevalence of anaemia in Vindhya region, extensive efforts should be made not only to correct anaemia, but to prevent anaemia. Various programmes for anaemia control should be executed more resourcefully to overcome it. Strong reinforcement of government scheme should be done at Anganwadi, CH, PHC to ensure prevention as well as early detection of anaemia.

Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

Background: Obstetrical hemorrhage is leading cause of maternal mortality. UAE is termed safe and effective method for resolving hemorrhage. objective of this study was to determine efficacy of uterine artery ligation in management of obstetrical hemorrhage.Methods: This cross sectional observational using non-probability convenient sampling technique was carried out for six months. After ethical approval, females between 18 to 35 years diagnosed with obstetrical hemorrhage, uterine atony refractory to medical treatment, having active bleeding from placental side or having normal coagulation profile were while females with post-partum hemorrhage because of retained products of conception, due to genital tract trauma or with disseminated intravascular coagulation were excluded. Analysis of data was done using SPSS version 23.0. Quantitative variables were reported as mean and standard deviation and for qualitative variables, frequency and percentages. Chi-square test was applied keeping p-value of <0.05 as statistically significant.Results: From 109 females with mean age 47±5.25 years. In comparison of parity distribution, 62 (56.88%) were multiparous and 47 (43.12%) were primiparous. Type of bleeding observed was antepartum 36(33.03%), peripartum 39 (35.78%) and postpartum in 34 (31.19%). Efficacy of uterine artery ligation in management of obstetric hemorrhage was observed to be 35 (32.11%). The efficacy of uterine artery ligation in management of obstetric hemorrhage in three categories of age groups reported significant association (p=0.0005) and type of bleeding (p=0.025).Conclusions: Efficacy of UAE in different types of obstetrical hemorrhage reported in our study was lower than expected in about one-third of females.

Unintended Formalin Injection instead of Local Anesthetic Agent: Its Causes & Management

Mistakes do happen in every profession instead of properprecautions. Mishaps are those unfortunate accidents thatoccur during treatment, some owing to inattention to detail,others being very unpredictable and some are due to thenegligence of the employee. Dental negligence may lead tosevere complications and may threaten one's life. This casereport presents an unconventional case of administeringformalin in lieu of local anesthesia in a dental clinic leading tochemical cellulitis and its management.

Plastic surgery in Ladakh: a novel initiative in trans Himalaya of India

Background: The super speciality care is not available in remote places in India. But the service of the plastic surgery can be taken to the remote district hospital by arranging plastic surgery camps thereby resulting in service to the poor, capacity building of the local doctors and infrastructure development of the remote hospital.Methods: It is a retrospective study, in which the author analysed the feasibility, management, difficulties and achievement of week long, annual plastic surgery camp in remote set up of a district hospital of Ladakh over three year from 2017 to 2019.Results: A total of 341 patients were included in this study of which 108 underwent various surgical interventions. The youngest operated was 5 months old and oldest was 86 years. Wide spectrum of deformity were seen and operated upon. Complication developed in only six patients (5.5%) which were managed successfully at Leh only. The immediate and long term follow-up result show no difference in surgical result as compared to those compared operated outside with negligible financial burden.Conclusions: Keeping in view the positive outcome, it is argued through this paper that such camps should be replicated in other remote locations all over India.

Psychopathology in patients with psoriasis: a cross-sectional clinical study

Background: Psoriasis is associated with a variety of psychological problems including poor self-esteem, sexual dysfunction, anxiety and depressive disorder and suicidal ideation. There are reports that patients with psoriasis may have significant psychiatric morbidity. The objective of the study is to evaluate the frequency of psychiatric disorders, frequency and nature of psychiatric symptoms in patients with psoriasis.Methods: 100 patients with psoriasis were evaluated and included for the study. Comprehensive Psychopathological Rating Scale (CPRS) is used for assessment of psychiatric symptoms and MINI Plus for assessing psychiatric disorders. Chi-square test was used to compare the proportions.Results: Patients with psoriasis had high frequency of psychiatric morbidity and was found to be 42%.Conclusions: Patients with psoriasis have more psychopathology and higher psychiatric morbidity which may further imply justifiable consultation liaison psychiatry in other speciality fields like Dermatology.

Hyponatremia induced by angiotensin converting enzyme inhibitors

Background: Hyponatraemia is commonly associated with disease conditions or as an adverse effect of certain drugs. Angiotensin converting enzyme inhibitor (ACEI) and angiotensin II receptor blockers are drugs that have been commonly prescribed for the treatment of hypertension and cardiac diseases. It has become important to evaluate and investigate the incidence of hyponatremia on consumption of these drugs. The study aims to observe the incidence of the adverse drug reaction-hyponatraemia in hypertensive patients on ACEI therapy.Methods: The patient抯 data was collected using proforma following which they were randomized into three groups receiving enalapril, ramipril and captipril. Serum sodium levels were assayed by direct ISE method. Statistical analysis of data was performed using SPSS version 21.0. Chi-square test was used to compare occurrence of hyponatremia in the patients on ACEI. P<0.5 was considered as statistically significant.Results: Among all, 26 (52%) of the study population administered with ACEI developed hyponatremia. Predisposition to develop hyponatremia was high in males compared to females. The study also revealed that Enalapril had a higher association with hyponatremia compared to other drugs.Conclusions: Hyponatremia was induced in 52% of patients taking ACEI. This study revealed that monitoring of serum sodium levels in the patients with ACEI administration will help to prevent unexpected adverse reactions like hyponatremia.

Stroke in Coronavirus Disease 2019: A Systematic Review / 대한뇌졸중학회지

Background@#and Purpose Various neurological findings including stroke in patients with coronavirus disease 2019 (COVID-19) have been described, although no clarity exists regarding the nature and pattern of this association. This systematic review aims to report the characteristics of stroke in patients with COVID-19. @*Methods@#Three authors independently searched Web of Science, Embase, Scopus, and PubMed starting from inception up to May 22, 2020. The data for individual patients was extracted where available from published reports including clinical and laboratory parameters and analysed for any significant associations between variables. @*Results@#We identified 30 relevant articles involving 115 patients with acute or subacute stroke with COVID-19. The mean±standard deviation age was 62.5±14.5 years. Stroke was ischemic in majority of the patients (101 [87.8%]). Hypertension (42 [42%]), dyslipidaemia (24 [26.1%]), and diabetes (23 [23.2%]) were the major vascular risk factors. Most of the patients (80 [85.1%]) had COVID-19 symptoms at the time of stroke with a median interval of 10 days to stroke from the diagnosis of COVID-19. Three-fourths (86 [74.8%]) of the patients were critically ill which frequently delayed the diagnosis of stroke. High levels of D-dimer, and ferritin were observed in these patients. Patients with COVID-19 and stroke had a high mortality (47.9%). Factors associated with mortality were intensive care unit admission, having two or more vascular risk factors, particularly smoking and high levels of D-dimer, C-reactive protein, and lactate dehydrogenase. @*Conclusions@#The association between stroke and COVID-19 is probably multifactorial including an amalgamation of traditional vascular risk factors, proinflammatory and a prothrombotic state. Prospectively collected data is required in the future to confirm this hypothesis.

A rare presentation of acute hyperglycemia with secondary mania: a case report

This case report aims to highlight the diagnostic challenges in consultation-liaison psychiatry in case of Type 1 Diabetes Mellitus. Author report the case of a 60-year-old male who presented to the Psychiatry OPD with first episode of mania. Although hypoglycaemia is known to be associated with multiple psychiatric manifestations, the incidence of psychiatric symptoms and disorders in association with hyperglycaemia is not well reported. This case report highlights the rare presentation of secondary mania in a patient with Type 1 Diabetes Mellitus.

Magnitude and pattern of birth defect babies at Bhopal district early intervention center under RBSK’s 4Ds approach: an observational study

Background: As per World Health Organization (WHO) congenital anomalies are also known as birth defects, congenital disorders or congenital malformations. Most common and severe congenital anomalies are congenital heart diseases, neural tube defect and Down’s syndrome. No data on the magnitude of congenital anomalies is available in India. Thus, the study aims to determine the magnitude and pattern of babies with birth defect reporting at District Early Intervention Center, Bhopal in children aged 0 to 6 years.Methods: This was an observational study conducted at DEIC, Bhopal under Rashtriya Bal Swasthya Karyakram services, over a period of one year. Children between 0 to 6 years visiting the center and belonging to Bhopal district were included in the study. Data entry was by Microsoft Excel and analysis was by Epi info.Results: 2891 children were registered for the study out of affected children 18.7% of them were diagnosed with Developmental delays while birth defect was observed in 4.3% cases. Of the birth defect cases majority i.e. 37.7% had congenital heart disease and 16.7% had congenital hearing loss. No case of retinopathy of prematurity was registered.Conclusions: The study also helps to know the magnitude and pattern of congenital anomalies. Any effective health intervention will reduce both direct costs and out-of-pocket expenditure.

A cross-sectional observational study on knowledge, attitude and practices about indiscriminate use of antibiotics and antibiotic resistance among medical doctors at Sapthagiri Hospital, Bangalore

Background: WHO defines Antimicrobial resistance (AMR) as “the ability of a microorganism to stop an antimicrobial from working against it”. The Global burden includes increased morbidity, prolonged illness and a higher mortality rate, along with economic burden. The cause can be tracked down to irrational usage of antibiotics and lack of awareness of rational prescribing practices.Methodology: A cross-sectional questionnaire-based observational study was carried out using a standard pre-validated questionnaire, which was administered to all the medical doctors present in their respective departments during the study period, exploring their knowledge regarding rational antibiotic usage, their attitudes and awareness towards AMR. Informed consent from the participants was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics.Results: Majority of doctors (91.3%) have a good knowledge and agree that indiscriminate use of antibiotics leads to antimicrobial resistance. 96.12% of doctors identify it as a global issue but only 85.5% consider it a problem in their hospital. Doctors (78%) have a positive attitude and do not prefer to prescribe an antibiotic for minor illnesses, but only 40% think it might contribute to antimicrobial resistance.Conclusion: Our study has demonstrated that doctors have a good knowledge about the emerging problem of antimicrobial resistance, however a minor percentage of doctors fail to acknowledge this at the level of their own hospital. Regular updates on the local antimicrobial resistance rates & antibiotic stewardship might help to control the global issue of AMR.