Snigdha Singh

Abstract

Background: Hospital waste has always been a concern for the society. Recently the government has changed the BMW handling rules in 2016. However, mere introduction of laws is not sufficient for proper disposal of BMW. Awareness of these laws is also essential. Hence, this study was conducted with the objectives to assess the Knowledge, awareness, attitude & practice (KAP) towards biomedical waste management in Health care providers (HCP) and prevalence of needle-stick injury (NSI) in them. Methodology: This was a cross-sectional study done from August 2018 to January 2019 in KIMS among 400 participants. A pre-tested, close ended questionnaire was used with few added questions related to new rules. Results: An overall average level of KAP among HCP and grade 4 workers regarding BMW Rules and management 2016 with 86.49% doctors, 91.04% dentists, 79.55% nurses and 80% grade 4 workers securing average marks in the assessment. Moreover, 14 (20 .59%) doctors, 10 (14 .71%) dentists, 30 (44 .12%) nurses and 14 (20.59%) grade 4 workers reported that they had experienced NSI in the past 12 months. Overall prevalence of NSI is found to be 17%. Conclusion: We found an average level of knowledge, attitude and practice among HCP and grade 4 workers regarding BMW management. It is recommended that regular monitoring and training are required at all levels of Health Care System and the rules should be sincerely followed and practiced.   Keywords: Needle stick injury, Health care providers, Occupational hazard, Biomedical waste, Vaccination.

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Background: Wrist fractures are one among the common injuries of the elderly leading to reduced quality of life and impaired functionality, if not treated and restored adequately. Factors like asymmetry of vestibular function, decreased plantar sensation, unstable posture and functional disability have been more commonly associated with fall related wrist fractures among the geriatric population. Since wrist fractures are considered as an indicator for fracture incidence in the future specially for hip fractures, preventive measures like improving balance, function of the balance system in the inner ear and feeling in people’s feet can be timely adopted which in addition might be helpful in rehabilitation of patients with fractured wrist. Objective: To determine effect of multi sensory training (MST) on posture (muscle strength), vestibular function, vibration perception, tactile sensation and functional ability compared to wrist stabilization training (WT) among elderly with fall related wrist fractures. Materials and Methods: Experimental research design was adopted for the study among the 130 follow up cases of wrist fracture where 88 participants were randomized to Multi-Sensory Training and 42 received Wrist stabilization Training. The training period was 12 weeks, with 4 supervised sessions by a physiotherapist and home exercises for both groups. Pre and post training measurements included Head Shake Test (HST), Semmes–Weinstein Monofilaments (SWM), Vibration perception Test, 10m Walk Test (10MWT), Five Times Sit to Stand Test (FTSTS), Activities Specific Balance Confidence (ABC) and Dizziness Handicap Inventory Scales (DHI). Results: FTSTS, ABC, DHI were found to be statistically significant between the 2 groups. In contrast to wrist stabilization training, MST was more helpful in improving HST (p=0.001). Conclusions: Vestibular function among the cases of wrist fracture was better with Multi Sensory Training. It may be applied as a routine training intervention post fracture treatment. A robust sample size can be taken up to generalize its effectiveness.   Keywords: Wrist fracture, Sensory function, Postural stability, Vestibular function, Vibration perception.

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Background: Needle stick injuries are preventable causes of fearsome diseases like Hepatitis B and HIV. In spite of this knowledge, the health care providers are quite negligent, and the institutional support too is compromised due to the increased demand for services. Objectives: The current study is a dipstick audit of the knowledge and practices on NSI (prevention and management) among exposed health care workers, with specific reference to HIV infection in a private health facility in Bhubaneswar city, using an unorthodox tool of Focus Group Discussions among the participants. Materials and Methods: The exercise was a part of the academic activity of health promotion on World AIDS Day 2021. Health care workers such as doctors, paramedical staff & utility staff voluntarily participated in the FGD session. Total 3 FGDs were conducted at 3 different places inside the hospital premises. Three moderators were selected previously and after discussing the theme of World AIDS Day, they guided the FGDs with similar probing questionnaires. The sessions were recorded with the help of a recorder and also noted down along with Sociograms. Result: The data gave a real picture of how even premier institutions are complacent regarding the problem. Only 27% knew about the SOPs, and in none of the stations,SOPs were displayed or a register was maintained regarding NSI in their work area. None of the participants were aware of Post Exposure Prophylaxis for the same. This indeed highlighted an ignored aspect of quality health care. Conclusion: The data was an eye-opener in a tertiary care center and from time to time there should be refresher training or sessions to increase the level of awareness.   Keywords: Needlestick injury, FGD, AIDS, Occupational hazards.

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Abstract

Introduction: Fractures of the distal radius (DRF) are the most common orthopedic injuries: one out of every six fractures presented at emergency department is a distal radius fracture. Almost two-thirds of these fractures are displaced and need to be reduced. Epidemiological studies point out that the age rate curve is bimodal and that the highest incidences are found in children and the elderly. DRF constitute 14% of all extremity injuries. They occur as a result of high or low energy trauma resulting in significant injury and impairment of function of the upper extremity. Randomized controlled trial has been attempted to scrutinize the best method for treating DRF, ranging from methods of conservative treatment to advanced strategies of plate osteo-synthesis. Materials and Methods: 124 Patients with 126 intra-articular distal radius fractures were studied, who met with predefined inclusion and exclusion criteria at Department of Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar from 1st October 2017 to 30th September 2019. They underwent different treatment interventions. The cases were followed for 12 months at regular intervals for serial clinical & radiological evaluation. Functional grading and pain scoring was done for different treatment modalities. Radiological grading was made based on union/ non-union of fracture. Results: Majority with wrist fracture were of age 20-40 years followed by the age group 61-80 years. Grip strength was reported better in surgical group(79.2%). Mode of treatment is statistically significant with Palmar flexion (p = 0.015), Supination (p=0.025) and Pronation (p Conclusion: The impetus for the inclination towards treatment of wrist fracture by surgery, mainly plating method, stands multifactorial and might bring better outcomes in terms of range and degree of movement, expedited recovery, lower chances of malunion and in a way, better prognosis and quality of life in case of DRF. Keywords: Distal radius fracture, Plating, Ellis approach, Unstable fracture, Pain score, Function score.

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