Socio-demographic profile of poisoning in children admitted to a tertiary hospital

Background: Childhood poisoning is a significant public health problem and is very important cause of mortality and morbidityin children. The offending substances used vary from place to place. The pattern of poisoning has been changing with new hazardsconstantly appearing due to the introduction of new drugs and chemicals. Childhood poisoning is usually accidental makingpoisoning a preventable problem. Objectives: To determine the socio-demographic and clinical profile and outcome of childhoodpoisoning in a tertiary care hospital. Materials and Methods: This prospective study was done over a period of 2-year in a tertiarycare hospital. We studied children <15 years of age who were admitted to our hospital with a history of poisoning. Children withhistory of food poisoning, snake bite, scorpion sting, and insect bites were excluded from the study. The demographic profile ofpatients, various substances of poisoning, mode of poisoning, and outcome of admitted children with poisoning were studied.Results: Among 200 children admitted with the history of poisoning, 126 (63%) were boys and 74 (37%) were girls. The majorityof the poisoning were accidental in nature and found to be common in the age group of 1-5 years, children from rural areas, and areof lower socio-economic status. Kerosene poisoning was the most common (35%) agent followed by organophosphorus poisoning(11%). 4 children died due to various complications of poisoning. Conclusion: Common household products were found to be themain source of poisoning in younger age groups from rural background, and the majority was accidental in nature. Educationalprograms toward creating awareness among public are necessary to reduce the incidence of poisoning in children

Radiological correlation with functional outcome in displaced proximal humerus fractures treated with locking plates: a prospective study of 35 cases

Background: The objective of this prospective study is to investigate the relationship between the functional outcome and the radiographic results of two-, three- and four part proximal humeral fractures treated with open reduction and fixation with PHILOS locking plate.Methods: 35 patients (30 males and 5 females) with displaced proximal humerus fracture were treated with PHILOS plating and studied prospectively. According to Neer’s classification there were 16 two part fracture (45%), 15 three part fracture (42%) and 4 four part fracture (13%). The healing of fracture, head shaft angle (HSA) and complications were evaluated radiologically with plain radiographs whereas the functional outcome was assessed by the Shoulder Pain and Disability Index (SPADI) at 6 weeks, 3 months, 6 months and 1 year after surgery.Results: In our study, patients treated with locking plates had mean forward flexion of 123°, abduction of 124°, mean external rotation of 30° and internal rotation 53° at 1 year follow-up. Maximum improvement in range of movement occurred between interval of 12 weeks to 24 weeks due to complete fracture union occurred approximately up to 12 weeks. The mean SPADI score at end of 1 year were 10.22, 10.38 and 10.20 for two, three and four part fractures respectively. Average postoperative and follow-up HSA's were 134.1±4.4 and 132.5±1.2 degrees, respectively. Varus progression was more prominent in patients with postoperative HSA <130 (p<0.001). Complications included impingement in 1 case, joint penetration by screw in 1 case, failure of fixation in 1 case and infection in 1 case.Conclusions: Fixed angle locked plate is an extremely useful implant for reconstruction and salvage of proximal humeral fractures. Precise surgical technique, stable fracture fixation and restoration of anatomical reduction are absolutely necessary for improved outcome

Understanding our seas: National Institute of Oceanography, Goa

The present article summarizes the research done at the CSIR–National Institute of Oceanography in 2014 in ocean science, resources and technology. Significant research has been conducted on air–sea interactions and coastal circulation, biogeochemistry, biology, marine geophysics, palaeoceanography, marine fishery, gas hydrates and wave energy. Technological advances covered topics like oceanographic tools. Major strides have been made in marine resources research and evaluation

Understanding our seas: National Institute of Oceanography, Goa

The present article summarizes the research done at the CSIR–National Institute of Oceanography in 2014 in ocean science, resources and technology. Significant research has been conducted on air–sea interactions and coastal circulation, biogeochemistry, biology, marine geophysics, palaeoceanography, marine fishery, gas hydrates and wave energy. Technological advances covered topics like oceanographic tools. Major strides have been made in marine resources research and evaluation

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

A multifaceted intervention to improve diagnosis and early management of hospitalised patients with suspected acute brain infections in Brazil, India, and Malawi: An international multicentre intervention study

Background Brain infections pose substantial challenges in diagnosis and management and carry high mortality and morbidity, especially in low-income and middle-income countries. We aimed to improve the diagnosis and early management of patients admitted to hospital (adults aged 16 years and older and children aged >28 days) with suspected acute brain infections at 13 hospitals in Brazil, India, and Malawi. Methods With hospital stakeholders, policy makers, and patient and public representatives, we co-designed a multifaceted clinical and laboratory intervention, informed by an evaluation of routine practice. The intervention, tailored for each setting, included a diagnostic and management algorithm, a lumbar puncture pack, a testing panel, and staff training. We used multivariable logistic regression and interrupted time series analysis to compare the coprimary outcomes—the percentage of patients achieving a syndromic diagnosis and the percentage achieving a microbiological diagnosis before and after the intervention. The study was registered at ClinicalTrials.gov (NCT04190303) and is complete. Findings Between Jan 5, 2021, and Nov 30, 2022, we screened 10 462 patients and enrolled a total of 2233 patients at 13 hospital sites connected to the four study centres in Brazil, India, and Malawi. 1376 (62%) were recruited before the intervention and 857 (38%) were recruited after the intervention. 2154 patients (96%) had assessment of the primary outcome (1330 [62%] patients recruited pre-intervention and 824 [38%] recruited post-intervention). The median age across centres was 23 years (IQR 6–44), with 1276 (59%) being adults aged 16 years or older and 888 (41%) children aged between 29 days and 15 years; 1264 (59%) patients were male and 890 (41%) were female. Data on race and ethnicity were not recorded. 1020 (77%) of 1320 patients received a syndromic diagnosis before the intervention, rising to 701 (86%) of 813 after the intervention (adjusted odds ratio [aOR] 1·81 [95% CI 1·40–2·34]; p<0·0001). A microbiological diagnosis was made in 294 (22%) of 1330 patients pre-intervention, increasing to 250 (30%) of 824 patients post-intervention (aOR 1·46 [95% CI 1·18–1·79]; p=0·00040). Interrupted time series analysis confirmed that these increases exceeded a modest underlying trend of improvement over time. The percentage receiving a lumbar puncture, time to appropriate therapy, and functional outcome also improved. Interpretation Diagnosis and management of patients with suspected acute brain infections improved following introduction of a simple intervention package across a diverse range of hospitals on three continents. The intervention is now being implemented in other settings as part of the WHO Meningitis Roadmap and encephalitis control initiatives

Frequency of HIV type 2 infections among blood donor population from India: A 10-year experience

Purpose: In India, HIV-2 epidemic is alongside with HIV-1. Blood banks are introducing nucleic acid testing (NAT) for screening. The limitation of NAT systems is the inability to detect HIV-2. Materials and Method : An analysis of HIV screening of a blood bank at a tertiary care center from 1998 to 2007 was carried out. Results : A total of 175026 donors were screened by serological assays and 789 were reactive for HIV antibody. Only 478 (61%) were confirmed positive by Western blot/immunoblot. There were 465 (97.2%) donations positive for HIV-1, 6 (1.3%) for HIV-2 (monotypic infection) and 7 (1.5%) for HIV-1 and HIV-2 (dual infection). Conclusion : We show the presence of HIV-2 infection among the blood donors and the need for incorporating HIV-2 detection also in the NAT systems