Journal of Multidisciplinary Research in Healthcare

Rampant, irrational and unscientific use of antimicrobials by the healthcare practitioners is adding to the problem of antimicrobial resistance. Therefore, it is of utmost importance to evolve and implement new policies, recommence research actions and pursue steps to manage the crisis of antimicrobial resistance, which can be accomplished by a well-designed Antimicrobial Stewardship programme. A prospective observational study aiming to investigate the use of antimicrobials in Intensive Care Units by means of an AMS programme was carried out in a 400 bedded tertiary level hospital in New Delhi with 140 ICU beds. This evidence-based study looks
into the prescription and consumption of antimicrobials, specifically in the ICUs, and attempts to corelate it with the resistance pattern of antimicrobials being used. All the patients being treated with antimicrobials, admitted in the ICUs of the hospital were selected for this descriptive research. Information associated with antimicrobials including the susceptibility pattern of isolates and full dosage regime of each patient from the group was obtained by conducting daily audits for a period of five months. Among the usage of different antimicrobial categories (antibacterial, antifungal and antiviral), the resistance percentage correlation was predominantly focused on the
antibacterial. However, the study suggests no conclusive direct or indirect correlation between the usage of an antibacterial (in terms of prescription and consumption) and its resistance, which itself could be a cause of concern for medical practitioners.

Purpose: To assess the contact lens compliance rate by using a self-administrated validated questionnaire, the level of awareness, compliance & detectable behavioral changes, patterns or trends in contact lens users.

Methods: A questionnaire ,Cross sectional prospective study to understand the compliance in contact lens wearers, the questionnaires were distributed randomly among the users at various clinical & optical outlets. Based on various studies, and taking into account time constraints the sample size of 40 was taken. The mean age of 24 years was taken without any ocular pathology and systemic disease affecting the ocular health.

Result: The majority of 87% of the subjects studied, preferred the monthly modality and 13 % preferred conventional yearly replacement lenses. Considering average duration of wear 64% of the subjects showed non- compliance and prolonged their wearing schedules beyond 8 hours. 38% of the contact lens users were not taking optimum care of the lens cases.

A majority of 50% of the subjects rated better cosmetic appearance the most important factor, while 25% of them rated cosmetic & better vision equally important. 68% knew the availability of extended wear contact lenses that can be worn during sleep. Optical outlets are the places where the patient is more motivated for soft contact lens.

Conclusion: Cost and convenience are two factors that must be considered when educating patients about proper lens care regimens. In addition, compliance is more likely if the patient is satisfied with the medical visit.

Purpose: Exposures to medical ionizing radiations elevate the risk of stochastic effects such as cancer in exposed individuals. It is of utmost importance to monitor the radiation doses delivered to patients and their optimization to reduce the associated radiation risks without limiting the diagnostic information.

Methods: Entrance surface air kerma (ESAK) in a total of 64 adult patients in diagnostic digital Xray examinations were calculated and effective doses were estimated as per International Atomic Energy Agency (IAEA).

Results: Median ESAK (mGy) and associated effective doses obtained were skull PA (0.45mGy, 0.005mSv) and skull Lat (0.25mGy, 0.003mSv). Results were compared with UK diagnostic reference levels and studies in India.

Conclusion: The comparison revealed that the calculated ESAK and effective dose values were less than the published literature. ESAK values reported in this study could further contribute to establishing LDRLs.

Objective: To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI)in emergency assessment of stroke in brain imaging from the review of literature.

Method: Relevant databases (PubMed, google scholar etc.) were searched and literature were reviewed from 1995 to 2019. Literature from non-Scopus and unauthorized authorizations was excluded.

Result: It was observed that for MRI DWI (Diffusion-weighted imaging) is preferred and in CT, axial sections are opted. In earlier studies, it was seen that neither CT nor MRI came out to besuperior. This may be due to the previous technology used. Some studies also, suggested that Diffusion-weighted imaging is highly accurate in diagnosis of stroke and also superior to CT. Another study suggested that SWI is a new approach in visualizing the hemorrhage in acute stroke. On one hand, evidence revealed that MRI is as good as CT. While on the other hand, literature concluded that CT angiography is good for intracranial and extracranial vasculature. Some studies suggested that CT is more reliable and is readily available for stroke.

Conclusion: Present study concludes that both diagnostic imaging modalities i.e., CT and MRI have their advantages in diagnosis of ischemic and hemorrhagic stroke. Also chances of stroke increases with increase in age. Other factors influencing the stroke diagnosis and treatment are type of stroke, diagnostic imaging modality available, and cost-effectiveness of diagnostic exams performed.

Background: Tuberculosis is a global health problem and leading cause of mortality and morbidity in the world. Correct diagnosis of tuberculosis is the main challenge for control of tuberculosis. World health organization has prioritized improving diagnostic guidelines and tests for TB diagnosis. Priority has been given for development of new Tuberculosis diagnostic methods. But diagnosis of Tuberculosis highly affected by quality specimen collected which has been given less attention. The aim of this is to assess Yielding accuracy of morning and spot sputum samples for diagnosis Mycobacterium tuberculosis using Gene Xpert Mycobacterium Tuberculosis (MTB)/Rifampicin Resistance (RIF).

Methodology: Cross sectional study was conducted and convenient sampling technique used to select participants. Checklists used to collect the data from April 1 to May 30, 2018 G.C. A total of two hundred twenty two (222) sputum samples from 111 suspected tuberculosis patients were analyzed using Gene Xpert MTB/RIF Assay. SPSS version 20 was used for statistical analysis. Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research show an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant association
with TB positivity.

Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not association with TB positivity using Gene Xpert MTB/RIF Assay.

Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research shows an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant association with TB positivity.

Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for the detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not associated with TB positivity using Gene Xpert MTB/RIF Assay.

National Capital Territory (NCT) of Delhi is experiencing rapid urbanization for the last few decades. The area is lagging behind in water and waste management infrastructure. This is due to the fact that Delhi is recording high growth rate of population mostly through in-migration over the year which is taxing much upon the existing water resources and the provisions made for water supply. Consequently demand is higher than supply of the safe drinking water. The consumption of unsafe drinking water is therefore increasing and is causing serious health problems among the fellow residents of NCT of Delhi. These health problems are basically related to the digestive as well as excretory systems of the human body. These disorders are promoting mortality particularly among those segments of population which do not have access to potable drinking water. This paper is therefore a modest attempt towards examining the population growth rate and the scenarios of demand and supply for potable water as well as the overall water related intestinal infections and related mortality at present and their future occurrence. This requires synergy between the different sectors of the state to overcome the problem. of intestinal infection diseases in the region.

A novel β-coronavirus (2019 novel coronavirus) affected severe as well to uniform fetal pneumonia, travelled through a seafood bazaar of Wuhan town, Hubei region, China, also quickly extent toward excess boonies of China and more nations. The 2019-nCoV existed dissimilar after SARS-CoV, then cooperative the similar crowd receptor the social ACE2 (angiotensin-converting enzyme2). The regular crowd of 2019 novel coronavirus could conventional continue bat Rhinolophusaffin is a 2019 novel coronavirus presented 96.2% of entire-genome character toward BatCoV RaTG13. The person-to-person spread methods of 2019-nCoV involved tool, identical cough, sneeze droplet inhalation transmission, and obtain in-tuned with transmission, just like the interaction by way of oral, nasal, as well as eye mucous films. 2019-nCoV container too exist spread over the saliva, also thus the fetal–oral ways similarly can remain a possible person-to-person spread mode. The observers now optometry run through representation just before the incredible danger of 2019-nCoV contagion because of the face-to-face announcement too thus the expose en route for tears, plasma, plus additional body liquids, besides therefore the diagnostic and treatment of apparatuses. Eye care professional perform inordinate heroes in stopping the spread of 2019-nCoV. At this time we indorse the contagion control actions all through optometry exercise just before block the person-to-person spread ways in eye care health center as well as hospitals.

We have reached far ahead today when it comes to the telemedicine technology which was first installed in Boston in 1967 that made a regular interaction between physicians and patients at distant locations. Being a developing and lower-middle income country, currently India faces shortage of doctors, nurses & midwives, and healthcare infrastructure. Around 70% of Indian population lives in remote and rural villages lacking access to basic healthcare facilities. In such situations telemedicine plays a great role in providing quality and affordable healthcare to India’s poorest people, and is expected to bridge the rural-urban health divide. Whether telemedicine technology meets its objective to provide adequate healthcare services to the poor remote and rural population is matter of great concern. This article aims to provide an overview on this issue.

Women’s mental health is a crucial and important aspect in her overall well-being but neglected as it is often asymptomatic. It is interesting to reflect on mental health for a woman who has multiple responsibilities – Her own, family, career, and responsibilities to the community and the impact it has on women career continuity and career progression. The ideal situation would be all for all groups to be partners and stakeholders in the same so that women can balance career along with other responsibilities. The article throws light on how postponing the career opportunities of women become a hurdle for her to restart her career and pacify her passion and how it affects the mental wellbeing.

Background: This study explores food beliefs among poor mothers related to feeding their offspring. Mothers’ misconception of a healthy diet is one of the major causes of nutritional problems in preschool-aged children in Nepal and these beliefs and attitudes can result in the inappropriate feeding of young children.

Objectives: The main objectives of this study were:

• identify major barriers for recommending healthy food that are associated with existing cultures, religions and ethnic divisions;
• assess the knowledge, attitudes, and beliefs about nutritious food amongst mothers;
• assess health-seeking behaviour for children of low socio-economic status.

Methods: Study used a qualitative focus group discussion. Fifty participants took part in seven focus groups to explore their food beliefs. The qualitative focus groups aimed to collect in-depth information around food beliefs and data were thematically analysed.

Results: The study identified six key themes: (a) poverty; (b) knowledge; (c) policy; (d) beliefs about breastfeeding; (e) food beliefs: and (f) health-seeking behaviours/cultural influences. Many participants thought that illiterate and underserved populations are generally exposed due to financial scarcity, poor knowledge and strongly rooted in cultural practices, and beliefs. This study found ‘diversified views’ as a major barrier to food and health-seeking behaviours. Some groups recognised the negative effects of existing beliefs and taboos. However, the spiritual healers highlighted the importance of linking beliefs with cultural and religious norms and values. They showed the complex relationships between food and health-seeking behaviours and food recommendations with financial status and the perceived cultural practices of society.

Conclusions: This study suggests that a public health approach is needed to address nutrition problems associated with behaviour and revealed major barriers which were associated with poverty, resources, and mothers’ education level.