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Background: Catheter Associated Urinary Tract Infections (CAUTI) contribute 30%-40% of all the nosocomial infections and they are associated with substantially increased institutional death rates. A multimodal supervision program which incorporates training of the staff with respect to infection control measures can be effective in reducing the CAUTIs in hospitals. Aim: To assess the impact of a multimodal UTI supervision program on the CAUTI rates over a year, from January 2009 to December 2009, in a tertiary care hospital in India. Setting: A 215 bedded tertiary care private hospital. Materials and Methods: The CAUTI rates were analyzed for the first 6 months (January 2009-June 2009). A UTI supervision program was instituted in the month of July 2009, which included training with respect to the standard protocols for the sample collection and diagnosis, the bundle components of the urinary catheter checklist and hand hygiene practices. The impact was assessed as per the CAUTI rates in the subsequent months. Results: The average CAUTI rate was reduced by 47.1% (from 10.6 to 5.6) after the introduction of the supervision program This study presented the mean age of the patients with CAUTIs as 54.5 years and it showed an approximately equal contribution of both the sexes (52.94% in males and 47.05% in females). The impact analysis of the supervision program showed a reduction of 8.7% (from 23 days to 21 days) during the average duration of the catheterization. The adherence to the components of the urinary catheter check list was increased by 44.4% (p=0.069) and the hand hygiene compliance was increased by 56.4% (p=0.004) respectively after the interventions. Components like bladder irrigation and practising perineal cleaning were found to show no effect on the CAUTI rates. Conclusion: The most common labour and cost effective infection control measures as revealed by the supervision programme were adherence to the urinary catheter checklist components (indication for catheter insertion and change, asepsis maintenance during and after the catheter insertion and avoiding urine reflux) and hand hygiene practices, whereas bladder irrigation and practising perineal cleaning thrice a day were unnecessary measures. [ABSTRACT FROM AUTHOR]

Objectives: To carry out a retrospective study on Acinetobacter baumannii isolates from various clinical samples in a tertiary care hospital in India and analyze its epidemiology, antibiotic susceptibility patterns, pathogenic potential and nosocomial status. Materials and methods: The clinical specimens over a period of 14 months from December 2008 to January 2010 were analyzed and the A.baumannii isolates obtained by an automated identification system (Vitek 2 Compact) were segregated for further study. Their antibiograms were studied and a clinical correlation was made to assess their pathogenic status and mode of acquisition. Further, the nosocomial infections acquired during this period were studied and the contribution made by A.baumannii was calculated to assess its nosocomial status. Results: A.baumannii was isolated in 155 samples out of 1632 gram negative isolates (9.4% prevalence) from the entire hospital. Maximum isolates were from respiratory secretions (57.4%) followed by blood (23.8%). Prevalence of A.baumannii rose to 22.7% (119 out of 525) in intensive care unit (ICU) and 65 isolates (54.6%) proved to be pathogenic. A.baumannii contributed to 30.4% ventilator associated pneumonia, 35.2% Catheter Associated Blood Stream Infections, 12.5% Surgical Site Infections and 2.94% Catheter Associated Urinary Tract Infections. Overall resistance of A.baumannii towards carbapenems was 90% from all hospital isolates. ICU isolates showed higher resistance (93.2%) as compared to Inpatient Department (82.7%) and Out-patient Department (57.1%). Conclusion: In this study, A.baumannii isolates showed a pathogenic potential of around 54.6% and a majority were found to be carbapenem resistant. We must be cognizant of the fact that all A.baumannii isolations doesn't necessarily mean infection and antibiotics should only be given in clinically proven infections. [ABSTRACT FROM AUTHOR]

Typhoid fever continues to be a major public health problem in developing countries especially due to the challenging infrastructure and sanitation facilities. Many cases of abortions due to untreated Salmonella infection have been reported. The present report is about a 25-year-old female who was inadequately treated for typhoid fever with suboptimal doses of oral ampicillin leading to inevitable abortion despite the infection being cleared from blood. Salmonella typhi was isolated from products of conception. The patient was treated with Ceftriaxone injections and has been found to be fine on follow-up visits. Typhoid during pregnancy needs to be treated with higher doses and preferably intravenous antibiotics instead of oral due to the increased volume of distribution and reduced tissue penetration of antibiotics in such patients. [ABSTRACT FROM AUTHOR]

Summary: Objective: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach on central line-associated bloodstream infection (CLABSI) rates in eight cities of India. Methods: This was a prospective, before-and-after cohort study of 35650 patients hospitalized in 16 adult intensive care units of 11 hospitals. During the baseline period, outcome surveillance of CLABSI was performed, applying the definitions of the CDC/NHSN (US Centers for Disease Control and Prevention/National Healthcare Safety Network). During the intervention, the INICC approach was implemented, which included a bundle of interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback. Random effects Poisson regression was used for clustering of CLABSI rates across time periods. Results: During the baseline period, 9472 central line (CL)-days and 61 CLABSIs were recorded; during the intervention period, 80898 CL-days and 404 CLABSIs were recorded. The baseline rate was 6.4 CLABSIs per 1000 CL-days, which was reduced to 3.9 CLABSIs per 1000 CL-days in the second year and maintained for 36 months of follow-up, accounting for a 53% CLABSI rate reduction (incidence rate ratio 0.47, 95% confidence interval 0.31–0.70; p =0.0001). Conclusions: Implementing the six components of the INICC approach simultaneously was associated with a significant reduction in the CLABSI rate in India, which remained stable during 36 months of follow-up. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the association of orthodontic tooth movement with the concentration of leptin in gingival crevicular fluid (GCF). Materials and Methods: In thirty orthodontic patients, the concentration of leptin was assessed at baseline, 1 h, 24 h, 7 days, and 1 month after application of orthodontic force. Distalized tooth movement was evaluated by measuring the difference on dental casts at baseline and 1 month after force application. Results: Average concentration of leptin in GCF raises from baseline (T0) to 1 h after application of force (T1). There was a significant association of the overall average concentration of leptin with the degree of tooth movement (correlation coefficient = 0.625). Conclusion: There was a biphasic change in GCF leptin concentration and significant association between rates of tooth movement with GCF leptin concentration. [ABSTRACT FROM AUTHOR]

Aim: Health professionals especially the dental professional are the frequent targets of musculoskeletal disorders (MSD). Complementary and alternative medicine (CAM) can be of some help in managing these MSD especially in. The purpose of this study was to determine the prevalence of CAM therapies as a treatment modality for MSD management among dental professionals of north India. Materials and Methods: Registered dentist of North Indian origin, India (n = 3598) were included in the study. The questionnaire was sent to all the dentists which consisted of the demographic profile, MSD in the past year, CAM therapies utilization and opinion about CAM therapies. Data analysis was done using SPSS version 21 and data were presented in tabular and graphic form. Test of significance was done using chi-square statistics with P < 0.05 considered as significant. Results: A response rate of 80% (n = 2879) was obtained, and all complained of MDS in some or the other part of their life. The use of CAM was reported among 70% (n = 2015) of the dentist who suffered from MSD. Other dentists either used conventional treatment or did not use anything. Conclusion: As the name implies, alternative medical systems is a category that extends beyond a single modality and refers to an entire system of theory and practice that developed separately from conventional medicine. CAM should be subject to rigorous scientific inquiry so that interventions that work are systematically distinguished from those that do not. In addition, the use of CAM treatments should be based on evidence of effectiveness and safety as demonstrated in randomized clinical trials. [ABSTRACT FROM AUTHOR]