Original Research Article
Feb. 13, 2020
Infection of Cardiac Implantable Electronic Devices: A Moroccan Single-Center Experience
Safae Harrak, Fatima Chikhi, Fellat Btissam, Oukerraj Latifa, Cherti Mohamed
None | 22-28
DOI : 10.36347/sasjm.2020.v06i02.002
Background: Increasing of Cardiac implantable electronic devices (CIEDs) have induced several complications such as infections. Our aim was to investigate the frequency of CIED infection, analyze the microbiological status and determinate contributing factors in order to prevent it. Patients and methods: We conducted a retrospective and descriptive study of patients who underwent implantation of electronic cardiac device in cardiology B department from January 2011 to June 2019. A total of 23 cases of CIED infection were identified. For each patient, all data were recorded about initial implantation of device and about CIED infection. Results: Frequency of CIED infection in our study is 1.2%. According to British guidelines, isolated local infection (uncomplicated PI) is observed in 8 patients (34.7%), local infection associated with sepsis (complicated PI) is found in 8 cases (34.7%) and 5 patients (21.7%) presented with systemic signs (ICED-LE and ICED-IE). Infection involve 17 patients with primary implantation and 6 patients after generator replacement.78% of patients, male and 56% are young and (≤60 years) and 39% are diabetics series is characterized by largest number of patients (78%) who consult for local signs. Biological assessment and blood cultures didn’t help to differentiate between local et systemic forms because blood tests were often negative. We noticed an increased negativity of bacteriological examinations. Conclusion: ICED-related infection affects, mainly, young male patients and frequently diabetics. These patients usually have been surgically revised for postoperative complications or underwent temporary wire before implantation. Often, it is systemic form induced by pocket infection. Biological and bacteriological tests are always negative. When the causative germ is isolated, it is often staphylococcus.
Original Research Article
Feb. 14, 2020
“A Study of Medication Adherence among Type 2 Diabetes Mellitus Patients in Tertiary Care Teaching Hospital, Mandya, Karnataka (India)”
Rajashekar S, Ramakrishna S, Shivakumar KM
None | 29-37
DOI : 10.36347/sasjm.2020.v06i02.003
Background: Diabetes mellitus (DM) is one among chronic disease requiring long term medication and its prevalence increasing globally. It is becoming a potential epidemic in India with more than 62 million diagnosed diabetics and an increase of nearly 2 million per year. Adherence to treatment is very important for good glycemic control. Poor adherence to medication regimens increases the probability of adverse outcomes in type 2 diabetes patients. Therefore, improving medication adherence is a growing priority to control this epidemic. Hence, this study was conducted to determine the level of adherence to medication in Type 2 diabetic patients and to study the various factors affecting adherence. Methods: A cross sectional study was conducted at medicine outpatient department (OPD) and general medical ward of a tertiary care teaching hospital, MIMS, Mandya, Karnataka, India. Among 200 type 2 diabetic patients for duration of 2 months using a predesigned and pretested semi-structured interview schedule and diabetes medication adherence was assessed by Morisky’s medication adherence scale questionnaire. Results: Out of 200 participants, 15 (7.5%) were found to have high adherence while 67 (33.5%) had moderate and 118 (59%) had low adherence. Factors found to be associated with non-adherence were older age (>60years), females, low education status, unemployment, longer duration of disease, people from villages, diabetics without family support, poor socioeconomic status, cost, complexity of drug regimens, frequent dosing, long duration of treatment, lack of knowledge of disease and medications, non-availability of medications and absence of glucometer. 76.27% of the patients had poor plasma glucose control. Conclusion: There is a need to focus on improving adherence among type 2 diabetes patients and strengthening health care systems for regular supply of medicines and provide health education to the patients and their families emphasizing the need of adherence.......
Dr. Hrishikesh. S. Pai, Dr. Varghese Che
Feb. 16, 2020
Knowledge and Practices about Breast Feeding in Accordance with the National Policy among Mothers in Baby Friendly Hospital
Dr. Hrishikesh. S. Pai, Dr. Varghese Cherian, Dr. Rojo Joy, Dr. Preethy Peter
None | 514-519
DOI : 10.36347/sjams.2020.v08i02.032
Breast milk is essential for the baby. All babies should receive exclusive breast milk for 6 months. The aim of Baby Friendly Hospital Initiative by WHO/UNICEF is to promote exclusive breast feeding. Hospitals which follow the steps of successful breastfeeding are accredited Baby Friendly status. But the practice of these steps varies considerably. This study is to determine the percentage of women experiencing ten steps to successful breastfeeding in tertiary care centre and to assess the practice of breastfeeding at 6 and 10 weeks. This hospital based Prospective descriptive study was conducted among 170 mothers delivering a term baby at tertiary care centre. A validated questionnaire was used to assess the practice of ten steps to successful breastfeeding in the hospital at the time of discharge and status of breastfeeding was assessed at 6 weeks and 14 weeks among these mothers. The results described in a simple descriptive manner comparing with previous studies.In this study Majority of mothers (73.5%) had seen written breastfeeding policy, 45.9% received antenatal counselling, 35.9 started breastfeeding within 30 min, 58.8% by 2 hours, 75.9% by 4 hours. One of main reason for delay in initiation of breastfeeding being cesarean section.70.6% were given training regarding how to breastfeed, majority among these being primi gravida. The rate of exclusive breastfeeding was 60% during hospital stay.78.8% mothers were taught when to feed baby or to feed the baby if baby slept too long. Follow up study at 6 weeks and 14 weeks showed 94.8% and 79% of the mothers respectively following exclusive breastfeeding. The rate of is exclusive breastfeeding is greatly influenced by the counseling and guidance mother receives antenatally as well as postnatally. It was particularly more if mother has experienced the ten steps of successful breastfeeding by WHO/UNICEF in a baby friendly hospital.