Risk factors for SARS-CoV-2 infection among health workers in India: a case control study.

Background: COVID-19 was declared as a Public Health Emergency of International Concern on 30th January 2020. Compared to the general population, healthcare workers and their families have been identified to be at a higher risk of getting infected with COVID-19. Therefore, it is crucial to understand the risk factors responsible for the transmission of SARS-CoV-2 infection among health workers in different hospital settings and to describe the range of clinical presentations of SARS-CoV-2 infection among them. Methodology: A nested case-control study was conducted among healthcare workers who were involved in the care of COVID-19 cases for assessing the risk factors associated with it. To get a holistic perspective, the study was conducted in 19 different hospitals from across 7 states (Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Gujarat, and Rajasthan) of India covering the major government and private hospitals that were actively involved in COVID-19 patient care. The study participants who were not vaccinated were enrolled using the incidence density sampling technique from December 2020 to December 2021. Results: A total of 973 health workers consisting of 345 cases and 628 controls were recruited for the study. The mean age of the participants was observed to be 31.17 ± 8.5 years, with 56.3% of them being females. On multivariate analysis, the factors that were found to be significantly associated with SARS-CoV-2 were age of more than 31 years (adjusted odds ratio [aOR] 1.407 [95% CI 1.53-1.880]; p = 0.021), male gender (aOR 1.342 [95% CI 1.019-1.768]; p = 0.036), practical mode of IPC training on personal protective equipment (aOR 1. 1.935 [95% CI 1.148-3.260]; p = 0.013), direct exposure to COVID-19 patient (aOR 1.413 [95% CI 1.006-1.985]; p = 0.046), presence of diabetes mellitus (aOR 2.895 [95% CI 1.079-7.770]; p = 0.035) and those received prophylactic treatment for COVID-19 in the last 14 days (aOR 1.866 [95% CI 0.201-2.901]; p = 0.006). Conclusion: The study was able to highlight the need for having a separate hospital infection control department that implements IPC programs regularly. The study also emphasizes the need for developing policies that address the occupational hazards faced by health workers.

Access, timeliness and retention for HIV testing under early infant diagnosis (EID) program, India.

Early Infant Diagnosis of HIV infection services are crucial for managing the perinatally acquired HIV infection. Assessing the performance of the EID services and its underlying determinants is important for the National AIDS Control Program, India. The objectives of this study were to find out access to HIV testing, the timeliness of the testing cascade, and the proportion of HIV exposed infants who are followed up to 18 months for a definitive diagnosis of HIV. The study design was a mixed method. A total of 11 states accounting for 80% of HIV-positive pregnant women were selected. Program records from a total of 62 Integrated counselling and testing centres (ICTCs) served as the source of information. The qualitative component included interviews of program managers at the state and district level, service providers at the ICTC level, and caregivers of HIV exposed infants. In the sampled 62 ICTCs, 78% of the HIV exposed infants had at least one HIV test. Of the infants who had HIV tests, 50% had at first sample collected by 8 weeks of age. The median turnaround time from sample collection to DNA PCR testing was 36 (IQR 19-70) days and that to next sample collection in case of detection of virus in the first sample was 66 (IQR 55-116) days. At 18 months of age, 544 (62%) HIV exposed infants were retained in the EID testing cascade. A total of 30 infants were diagnosed with HIV at a median age of 421 (IQR 149-650) days. More than three fourth of the HIV exposed infants had access to early infant diagnosis (EID) services. Both demand and supply-side factors contribute to access, timeliness and retention and there is a need to address these factors.

Evaluation of Electrocautery and Stainless Steel Scalpel in Oral Mucoperiosteal Incision for Mandibular Anterior Fracture.

BACKGROUND: Traditionally, mucosal incisions are made by stainless steel scalpel due to its ease of use, accuracy, and minimal tissue damage effect, but these incisions are more bloody and painful. To obviate the inherent disadvantages of scalpel, surgical diathermy was introduced at the beginning of the 20th century. AIM AND OBJECTIVES: The study aimed to compare the efficacy of electrocautery and stainless steel scalpel in oral mucoperiosteal incisions in terms of time taken for incision, blood loss, pain, edema, and healing for mandibular symphysis or parasymphysis fracture. MATERIALS AND METHODS: Forty patients who reported to the Department of Oral and Maxillofacial Surgery between December 2015 and November 2017 with symphysis or parasymphysis fracture were divided into two groups by randomized envelope method. RESULTS: The mean time taken and mean blood loss for electrocautery were less than that of stainless steel scalpel. The postoperative pain was significantly reduced at 24 h, 48 h, and 1 week in the diathermy group as compared to the scalpel group. At 24 h and 48 h, the extraoral edema measured was not significant. Wound healing at 24 h and 48 h was better in the scalpel group as compared to the electrocautery group. CONCLUSION: From present study, we can conclude that electrocautery is better than stainless steel scalpel in relation to time taken for incision, intraoperative blood loss and postoperative pain.

Comparison of Erich arch bar versus embrasure wires for intraoperative intermaxillary fixation in mandibular fractures.

PURPOSE: Intermaxillary fixation (IMF) is a fundamental principle in the management of mandibular fractures but with recent advent of open reduction and internal fixation (ORIF), use of IMF is almost limited intraoperatively. Therefore, we compared the efficacy of Erich arch bar versus embrasure wires for intraoperative IMF in mandibular fractures. METHOD: This prospective study was comprised of 50 patients with mandibular fractures who required ORIF with intraoperative IMF. Patients were categorized into two groups of 25 patients each: Erich arch bar technique was used for group A and embrasure wire technique for group B. Parameters were time taken for IMF, needle stick injury, occlusal stability, iatrogenic complications, and periodontal status of patients. STATISTICAL ANALYSIS: Chi-squared test and unpaired t test analyses was run on IBM SPSS 21.0 version (2015) software. RESULT: Mean time for placing embrasure wire (3.48 min) was significantly less than that for Erich arch bar (48.08 min). Needle stick injury rates to the operator as well as the assistants were significantly less when using the embrasure wire than the Erich arch bar. The Erich arch bar had significantly superior postoperative occlusion stability. Iatrogenic injury was more common when placing the Erich arch bar than the embrasure wire. Postoperative oral hygiene status was good in patients that received the embrasure wire. CONCLUSION: Embrasure wire technique is a quick, easy, and reliable technique for minimally or moderately displaced fractured mandible and had better clinical outcomes than did patients that underwent the Erich arch bar technique.

Pleomorphic Adenoma of Minor Salivary Gland Arising de novo in the Parapharyngeal Space- A Rare Case Report.

Parapharyngeal space tumours are rare. Pleomorphic adenoma is the commonest salivary gland tumour that is found in this space. This tumour may arise in the deep lobe of parotid gland and extend into the parapharyngeal space or may arise de novo from the aberrant minor salivary glands in parapharyngeal space. The latter entity is an extremely rare finding. CT scan and fine-needle aspiration cytology form the important diagnostic tools in case of these tumours. Surgery is the mainstay for the treatment of these tumours. The strategic location and also the extension of these tumours may at times demand to alter the surgical procedure for their excision. This article presents a case of a 27-year-old female, who presented with a mass in the right submandibular region that was excised successfully using transcervical approach in conjunction with transoral approach without mandibulotomy. The biopsy report suggested it to be "pleomorphic adenoma of minor salivary gland".

Multiple supramassetric dystrophic calcinosis.

Dystrophic calcification is deposition of calcium salt in degenerated tissues in the presence of normal calcium and phosphorous metabolism. It usually occurs in injured tissues. The condition may be associated with a variety of systemic disorders. The pathophysiology is still unclear. The case of a 17-year-old boy with dystrophic calcifications over the right masseter muscle is presented here with review of literature. Calcified nodules were surgically excised via an intraoral approach.

Multiple glass pieces in paranasal sinuses.

Here, a case has been reported of a road traffic accident with multiple glass pieces arranged in an unusual pattern in the left maxillary sinus, ethmoid sinus, nasopharynx and medial side of the orbit, as seen in the radiographs. Combined surgical approach through the existing wound and endoscopic surgery was successfully used to remove nearly all the glass pieces.