Epidemiological investigation into the source of water contamination at a tertiary care cancer hospital

Background: Water quality impacts the performance of the hospitals and leads to drastic health service deterioration affecting infection control programs, along with safety of the patients and staff. Good quality water is an essential prerequisite to ensure optimal patient care, and the well-being of the staff and visitors in a hospital environment. Objectives was to study the current water supply and treatment system in the cancer hospital. Also, to carryout root cause analysis of the causes of episodes of diarrhoea amongst patients and staff and to identify the source of infection and suggest improvement in the existing system to prevent recurrence.Methods: There were 25 reported cases of diarrhoea and other gastrointestinal symptoms between May 12 and June 2 2017, allegedly due to water contamination occurring in admitted patients and staff of a tertiary care cancer hospital in north India. This was reported to Hospital Administration, which prompted an epidemiological investigation.Results: Formation of Biofilms on the plastic taps was found to be the main reason for contamination of water.Conclusions: It was very clear that deposition of biofilm within the plastic taps was the main reason of diarrhea among the patients.

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Control of an Outbreak ofAcinetobacter baumanniiin Burn Unit in a Tertiary Care Hospital of North India

Advances in Public Health ◽

10.1155/2014/896289 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Shweta Sharma ◽

Nirmaljit Kaur ◽

Shalini Malhotra ◽

Preeti Madan ◽

Charoo Hans

Keyword(s):

Infection Control ◽

Acinetobacter Baumannii ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Multidrug Resistant ◽

Control Measures ◽

Hospital Environment ◽

North India ◽

Care Hospital ◽

Burn Unit

Acinetobacterinfection is increasing in hospitals and now it is considered as a global threat, as it can be easily transmitted and remain viable in the hospital environment for a long time due to its multidrug-resistant status, resistance to desiccation, and tendency to adhere to inanimate surfaces. Outbreaks caused by multidrug-resistantAcinetobacter baumannii(MDRAB) are difficult to control and have substantial morbidity and mortality, especially in vulnerable host. Here we are describing an outbreak of multidrug-resistantAcinetobacter baumanniiin burn unit of a tertiary care hospital in India followed by its investigation and infection control measures taken to curtail the outbreak. Outbreak investigation and environmental sampling are the key factors which help in deciding the infection control strategies for control of outbreak. Implementation of contact precautions, hand hygiene, personnel protective equipment, environmental disinfection, isolation of patients, and training of health care workers are effective measures to control the outbreak of MDRAB in burn unit.

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Descriptive audit of maternal sepsis in a tertiary care centre of North India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175530 ◽

2017 ◽

Vol 7 (1) ◽

pp. 124

Author(s):

Archana Kumari ◽

Jyotsna Suri ◽

Pratima Mittal

Keyword(s):

Critical Care ◽

Maternal Mortality ◽

Critical Care Unit ◽

Tertiary Care ◽

North India ◽

Care Centre ◽

Tertiary Care Centre ◽

Live Births ◽

Source Of Infection ◽

Maternal Sepsis

Background: Maternal sepsis is one of the leading causes of maternal mortality around the world. The aim of this study was to study the prevalence, clinical profile and fetomaternal outcome of maternal sepsis at a dedicated Obstetric critical care unit of a tertiary care centre of North India. It was retrospective study conducted in tertiary care centre in North IndiaMethods: Women diagnosed as sepsis or septic shock at any point in pregnancy and up to 6 weeks postpartum (irrespective of the source of infection) were included in the study. Demographic, clinical, microbiological and outcome data were recorded from the case sheets of all patients admitted in obstetrical critical care unit between January to December 2016. Outcome measures: Prevalence, bacterial organism, source of infection, mode of delivery, period of gestation, maternal and fetal outcome.Results: The prevalence of maternal sepsis was 16.5/10,000 live births. The number of maternal deaths attributable to sepsis were 35, making the maternal mortality ratio due to sepsis 128/100,000 live births. 87% of the cases were unbooked. 22% presented antenatally while 58% were postpartum and 20% were postabortal. Genital tract infection was most common source of infection. E. coli was the predominant organism in 28% followed by Methicillin resistant staphylococcus aureus in 12%. The mortality from sepsis was very high (78%). 54% of cases required mechanical ventilation and around 7% had to be shifted to intensive care unit for advanced life support and care. Sepsis was associated with preterm delivery and a high perinatal mortality rate.Conclusions: Early recognition of the severity of infection and prompt management by a multidisciplinary team of intensivists, anesthetists, neonatologists, obstetrician, midwives are the key to success. Vigilant infection control measures must be strictly practiced during all pregnancy events.

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Stroke Associated Infection: A Prospective Hospital-Based Study at Tertiary Care Institution of North India

JMS SKIMS ◽

10.33883/jms.v15i1.200 ◽

2012 ◽

Vol 15 (1) ◽

pp. 22-27

Author(s):

M Maqbool Wani ◽

Sheikh M Saleem ◽

Rangrez Imran ◽

Feroz Shaheen ◽

Tariq Wani ◽

...

Keyword(s):

Tertiary Care ◽

Binary Logistic Regression ◽

Patient Characteristics ◽

North India ◽

Binary Logistic Regression Analysis ◽

Comorbid Illness ◽

Anterior Circulation ◽

Source Of Infection ◽

Study Population ◽

Tertiary Care Institution

BACKGROUND: Immune dysfunction is increasingly recognized to be contributing to stroke associated infections. OBJECTIVE: The present study was aimed to study the magnitude of the stroke associated infection in a mixed population of hemorrhagic and ischemic strokes and its predisposing f actors. MATERIAL &METHODS: The study population consisted of 173 consecutive stroke admissions at SKIMS Srinagar, a tertiary core hospital. The patients developing fever at admission or in hospital were included and underwent neuroimaging and workup for the source of infection. The follow up was done upto death or discharg e of the patient. A univariate and binary logistic regression analysis was done to find the patient characteristics associated with infection. RESULTS: The stroke subtypes in the study were 60.1% hemorrhagic and 39.9% ischemic strokes. The majority of hemorrhagic strokes (65A%) were located in putamina while as anterior circulation territory contributed about 80% of the ischemic strokes. Fifty eight (33.5%) patients developed stroke associated infection. Chest was the source of infection in 58.6% of the cases. The culture positivity rate was poor (18.9%) in the patient study. The presence of a comorbid illness {OR 3.4), volume of hematoma (OR 4,7). and ventricular extension of the hemorrhoge (OR 4.9) significantly increased the odds ratio of stroke associated infection. CONCLUSIONS: The frequency of post stroke infection is around 33%, chest being the commonest source. Presence of a comorbid illness, volume of hemorrhage a nd ventricular extension increase the risk of infection . JMS 2012; 15(1):22-27

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Retrospective Analysis of Etiology, Incidence and Management of Facial Trauma Over 5 Years in North India: A Clinical Audit

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1145 ◽

2015 ◽

Vol 49 (2) ◽

pp. 59-61

Author(s):

Rohit Sharma ◽

Vandana Esht ◽

Pallvi Goomer

Keyword(s):

Retrospective Analysis ◽

Sports Injuries ◽

Clinical Audit ◽

Tertiary Care ◽

Well Being ◽

North India ◽

Facial Trauma ◽

Etiologic Factor ◽

Mandibular Fractures ◽

Midface Fractures

ABSTRACT Aim To analyze etiology, incidence and management of facial trauma over a period of 5 years in a tertiary care center in North India. Materials and methods Records of 195 patients with 274 facial fractures were analyzed retrospectively from 2009 to 2013. Fractures were classified according to anatomical area involved (zygoma, maxilla, mandible, teeth), and etiology was divided into road traffic accidents (RTAs), falls, sports injuries and assaults. It was found that RTA was most common etiologic factor for facial trauma, followed by falls, assaults and sports injuries. Mandibular fractures were most common, followed by midface fractures and dental injuries. Various treatment options were also evaluated. Results Mandibular fractures were more common than midface fractures. Most common line of treatment was open reduction and internal fixation with mini-plate fixation. Mandible reconstruction was done in one case of bone defect following a gun-shot injury. Coronoidectomy had to be performed in one case of zygoma fracture. Conclusion Patient's best interest, affordability and general well being should be kept in mind while managing trauma of maxillofacial region. Surgeon should utilize his knowledge to the best possible level as any injury to this region has a direct impact on psyche as well as general well being of patient. How to cite this article Sharma R, Esht V, Goomer P. Retrospective Analysis of Etiology, Incidence and Management of Facial Trauma Over 5 Years in North India: A Clinical Audit. J Postgrad Med Edu Res 2015;49(2):59-61.

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Study to Assess the Utility of Discrete Event Simulation Software in Projection & Optimization of Resources in Out-Patient Department at an Apex Cancer Institute in India: A Simulation Based Study

10.21203/rs.3.rs-131281/v1 ◽

2020 ◽

Author(s):

Angel Singh ◽

Anant Gupta ◽

Sidhartha Satpathy ◽

Naveen Gowda

Keyword(s):

Simulation Model ◽

Discrete Event Simulation ◽

Tertiary Care ◽

Discrete Event ◽

Support Staff ◽

Simulation Software ◽

North India ◽

Event Simulation ◽

Cancer Hospital ◽

Patient Load

Abstract BackgroundHealthcare is growing more complex with mandate expanding from the primary function of providing care to include economic, legislative and social conditions that has led to the rise of numerous ancillary services. These have necessitated multiple new processes and systems which are closely intertwined. A study was done to create and run a discrete event simulation in OPD of a tertiary care cancer hospital of North India to project and optimize resource deployment.MethodsThe OPD process & workflow as per the expected load at tertiary care cancer hospital were finalized with various stakeholders in a focused group discussion. The finalized OPD process & workflow along with the OPD Building plans were utilized to develop a discrete event simulation model for the OPD at tertiary care cancer hospital using a DES. The simulation model thus developed was tested with incremental patient loads in 5 different scenarios/ “What if” situations (Scenario 1-5). The data regarding initial patient load and resources deployed was taken from on ground observations at tertiary care cancer hospital. ResultsIt was found that rooms and doctors were over-utilized and support staff utilization remained low. This was implemented with lesser waiting time for patients. No additional support staff was provided thus improving utilization of existing staff and saving on resources. The simulations enabled us to deploy resources just when it was required, which ensured optimal utilization and better efficiency. The peak census helped us to determine the capacity of the waiting area in different scenarios with incremental patient load and resource deployment.ConclusionThe Simulation software was very helpful, as “what if scenarios” could be created and the system tested, without disturbing the normal functioning of OPD. This enabled decision making before making on ground changes which saved lot of time and money.

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Abstract #803815: Prevalence of Gestational Diabetes Mellitus in Women with High Risk Factors at a Tertiary Care Hospital in North India

Endocrine Practice ◽

10.1016/s1530-891x(20)39556-2 ◽

2020 ◽

Vol 26 ◽

pp. 109-110

Author(s):

Smiti Nanda

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

High Risk Factors

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Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽

10.33883/jms.v23i1.747 ◽

2020 ◽

Vol 23 (1) ◽

pp. 48-49

Author(s):

Javaid Ahmad Bhat ◽

Shariq Rashid Masoodi

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Tertiary Care ◽

Resistance Mechanisms ◽

North India ◽

Global Public Health ◽

Care Centre ◽

Tertiary Care Centre ◽

Effective Prevention ◽

Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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