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A pilot randomized controlled trial comparing noradrenaline and adrenaline as a first-line vasopressor for fluid-refractory septic shock in neonates
(PUBMED, 2024-10-13) Reema Garegrat1 ,; Suprabha Patnaik; Sonali Suryawanshi; Chinmay Chetan; Nishant Banait; Pari Singh; Aditya Kallimath; Naharmal B. Soni; Yogen Singh; Pradeep Suryawanshi
Background and study design: Limited data exists on noradrenaline therapy in neonatal septic shock. We compared the efficacy of noradrenaline with adrenaline in neonatal septic shock. This single center, open label, pilot randomized controlled trial included neonates with clinical evidence of sepsis and shock. Study outcomes: Primary outcomes were: 1) resolution of shock one hour after treatment, and 2) mortality during hospital stay. Secondary outcomes included: need for additional vasopressors; hemodynamic stability without further administration of vasopressors for ≥2 h; changes in blood pressure and heart rate after 1 h of vasopressor treatment; and morbidities during the hospital stay. Results: Of 65 eligible neonates, 42 were randomized (21 each in adrenaline and noradrenaline treatment arms) between August 2020 and January 2022, at level III neonatal intensive care unit (NICU) of Bharati Vidyapeeth Deemed University Medical College and Hospital (BVDUMCH). The mean (SD) gestational age and mean (SD) birth weight were 36.1(4.2) weeks and 1.8 (0.2) kilograms birth weight for noradrenaline and 36.9 (4.1) weeks and 1.7 (0.7) kilograms for adrenaline. Shock resolved within 1 h of vasopressor therapy in 76.2% neonates in the noradrenaline arm and 61.9% in adrenaline arm (p value-0.53). Mortality during hospital stay was 28.6% (6/21) in noradrenaline group and 33.3% (7/21) in adrenaline group (p value- 0.58). Additional vasopressors were required in 23.8% neonates of the noradrenaline group compared to 38.1% neonates in adrenaline arm (p value-0.53). Median (SD) duration of intensive care stay was 6 (SD) days in the noradrenaline group and 10 (SD) days in the adrenaline group (p value-0.045). Conclusion: Among neonates with septic shock, the efficacy of noradrenaline was comparable to adrenaline in resolving septic shock after one hour of infusion and on the mortality during hospital stay
A Study of Clinical Profile of Retinal Diseases in Premature Infants
(EuroPub, 2025-06-06) Priyanka Narula; Renu Dhasmana; Saikat Patra; Udit Raj Sharma
Purpose: Retinal diseases in premature infants, particularly retinopathy of prematurity (ROP), are significant causes of childhood blindness worldwide. The prevalence and severity of these conditions are influenced by various factors, including gestational age, birth weight, and neonatal care quality. This study aims to analyze the clinical profile of retinal diseases in premature infants visiting or admitted to the Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand. Methods: The present observational study was conducted in the Department of Ophthalmology, Himalayan Institute of Medical Sciences (HIMS), Swami Rama Himalayan University, Dehradun over a period of 12 months. Preterm neonates attending ophthalmology or pediatric outpatient department or admitted in neonatal intensive care unit of Himalayan hospital were included in the study. Premature infants born before 37 weeks of gestation were screened for retinal diseases using indirect ophthalmoscopy. Data on gestational age, birth weight, oxygen therapy, and other relevant clinical parameters was collected. Results: Of the total 101 patients studied, 62 (61.4%) had retinal disease. Males had significantly higher proportion of retinal disease 42 (67.7%) as compared to females 20 (32.2%). P value 0.012. The incidence of ROP was found to be 62 (61.4%). Significant risk factors for the development of retinal diseases included low gestational age, birth asphyxia, ventilator support, oxygen administration and delivew by cesarean section. Conclusion: The study highlights the need for early screening and intervention for retinal diseases in premature infants, particularly those with identified risk factors.
Alarming medication error with prostaglandin E1 (PGE1) in a term neonate with critical congenital heart disease
(BMJ case report, 2024-04-08) Saikat Patra; Prachi Patwal; Chinmay Chetan; Girish Gupta
An outborn full-term female newborn with birth weight 2.45kg was admitted to our centre at 24 hours of life with respiratory distress and cyanosis. The baby had tachycardia and oxygen saturation (SpO2 ) 40% at admission to neonatal intensive care unit (NICU). She was mechanically ventilated on synchronized intermittent mandatory ventilation (SIMV) mode. Clinical evaluation raised suspicion of critical congenital heart disease; echocardiogram revealed transposition of the great arteries with 6mm ostium secundum atrial septal defect and small patent ductus arteriosus. The baby was started only on intravenous prostaglandin E1 (PGE1) as per unit protocol, where 1 ampoule (500 µg) of PGE1 is mixed in 49mL of 5% dextrose yielding a concentration of 10 µg/mL and is then started using an infusion pump at a rate of 0.6mL/kg/hour to provide a dose of 0.1 µg/kg/min. She developed tachycardia along with confluent erythematous macules over the scalp, face, neck and trunk, 10 hours after starting PGE1 infusion (figure 1). There was no associated fever or hypertension, while lowest blood pressure recorded was 52/30mm Hg. The skin rash, characterised by bright erythematous macular lesions, rapidly spread to the extremities. It was noticed that PGE1 was wrongly administered at 10 times the expected dose for the last 2hours prior to the cutaneous manifestation. The infusion was immediately stopped, and the baby was given
ARIMA based projection of infant mortality rate by the year 2030: a comparative analysis of India and Madhya Pradesh
(SCOPUS, 2025) Abhinav Bahuguna; Akanksha Uniyal; Vidisha Vallabh
Background Infant mortality is an important predictor of a government’s commitment to its people. Global infant deaths have declined since past decades but at a pace that leaves much to be desired. India’s declining pattern of trends is encouraging but the low performance of individual states like Madhya Pradesh (MP) indicates an urgent need for policy revision and implementation. Methods This paper forecasts the Infant mortality rate (IMR) of India and MP by the year 2030 through autoregressive integrated moving average (ARIMA) model after obtaining stationarity by differencing the series of IMR once. The Akaike’s information criterion and Bayesian information criterion have been used for the selection of best ARIMA model amongst other existing choices. The model diagnostics through Ljung and Box test shows absence of autocorrelation in the residuals (p>0.05). Results The findings through ARIMA(3, 1, 0) foretell a declining IMR from 27 to 20 per thousand live births (from 2021 to 2030) in India. Similarly, MP is expected to experience reduction in infant deaths from 44 to 39 per thousand live births (from 2021 to 2030). The deployed model is well fitted as mean absolute percentage error lies below 5%. During 2010–20, India and MP witnessed a decadal reduction of 40% and 31% in IMR, respectively. From the year 2010 onwards, India experienced the highest annual reduction of 8.1% in IMR during 2015–16. Similarly, MP encountered a decrease of 6.5% in IMR recently (2019–20), which is the highest declining annual IMR in the state during past ten years. Conclusions The projected figures on IMR are satisfactory for policy makers at national level, but MP is still miles away to achieve acceptable IMR as compared to the country’s IMR. The state requires more attention and focus on exploring reasons and identifying underlying factors responsible for higher IMR across its demographic structure including socio-economic characteristics.
Assessment of awareness on basic life support among healthcare workers in a tertiary care teaching hospital in northern region of India
(Springer, 2025-08-30) Himadri Mamgain; Omkarnath Sivarchaka; Sundar Lal Jethani; Vaibhav
Background Basic Life Support (BLS) serves as the basis for preserving lives following cardiac arrest, especially considering that heart disease ranks as the leading cause of death and constitutes a silent epidemic within the Indian population. Ischemic Heart Disease (IHD) stands out as the primary global cause of mortality, concurrently contributing significantly to the loss of disability-adjusted life years (DALYs). Hence it is crucial for healthcare workers (HCW) to have substantial knowledge and awareness of BLS to help patients when they need it the most. This study aimed to assess the awareness on BLS among HCWs in a tertiary care teaching hospital. Methods A cross-sectional study was conducted among HCWs in a tertiary care teaching hospital. A self-administered questionnaire was developed to assess knowledge on key BLS components, including cardiopulmonary resuscitation (CPR) techniques, use of an automated external defibrillator (AED), and the chain of survival. Data were analyzed using descriptive statistics and chi-square tests. Results Out of 206 responders, 60 were doctors, 122 were nursing staff and 24 were technicians. None of the responders have complete knowledge of basic life support, 58.8% mean percentage of knowledge. There was a significant difference in BLS knowledge between different professional groups, with doctors scoring higher than nurses and paramedics (p<0.001). Conclusion Even though healthcare professionals receive BLS training at a high rate, there remains a knowledge and retention gap in BLS abilities. Regular skills practice and updated training is recommended to enhance BLS proficiency.
Assessment of Central Catheter Tip Position in Neonates by Ultrasonography Versus X-ray
(SCOPUS, 2024-06-01) Prachi Patwal; Chinmay Chetan; Brajendra Singh; Vinayak Madhukar Jedhe; Girish Gupta
Central catheters are frequently inserted in neonatal intensive care units. The tip of these catheters should be in the correct position; otherwise, it may lead to life-threatening complications. X-ray has been universally used as a standard imaging modality to localize the position of central lines. Ultrasonography is an upcoming promising modality. We compared the catheter tip localization using ultrasonography versus X-ray.
Biotinidase deficiency-masquerade of primary immunodeficiency disease in neonate
(PUBMED, 2024-12-15) Chinmay Chetan; Brajendra Singh; Saikat Patra; Girish Gupta
Biotinidase deficiency, a rare metabolic disorder characterised by abnormal biotin metabolism, affects the biotin-dependent carboxylase functions. Primarily characterised by neurological and skin disorder, it may present with myriad features. Early recognition is important for preventing long-term morbidities. Here, we describe a case of a neonate presenting with seizures and a clinical picture suggestive of immunodeficiency. Multiple superficial abscesses along with septic arthritis of the left knee and left hip led to suspicion of primary immunodeficiency disorder. On evaluation, there was severe biotinidase deficiency. The neonate was supplemented with biotin, after which there were no further episodes of severe infection requiring hospitalisation, seizures or skin manifestation. This case report highlights the wide spectrum of clinical picture these disorders may present with and the low threshold for their evaluation and treatment.
Comparative performance of biofire pneumonia panel and standard culture-based methods for diagnosing pneumonia in critically ill patients: Impact on antibiotic stewardship
(Elsevier, 2024-04-22) Barnali Kakati; Rajender Singh; Garima Mittal; Nupur Koul
Introduction: Lower respiratory tract infections (LRTIs) are a common cause of morbidity and mortality worldwide. Accurate identification of the pathogens causing LRTIs is crucial for ensuring of diagnostic and antibiotic stewardship. The Biofire Pneumonia Panel (BFPP) is a molecular diagnostic test that allows rapid detection of various bacterial and viral pathogens. In this study, we compared the performance of BFPP with standard culture methods for the detection of pathogens. Materials and methods: Respiratory samples from 70 patient with suspected LRTIs were tested using both BFPP and standard culture methods. The distribution of isolated bacterial pathogens was analyzed, and the sensitivity and specificity of BFPP were calculated. Additionally, the performance of BFPP in detecting antimicrobial resistance genes was evaluated. The results were compared with those obtained from VITEK-2 antimicrobial susceptibility testing and culture-based methods. Results: Among the suspected LRTI cases, BFPP identified a single pathogen in 32.8% of cases and multiple pathogens in 40% of cases. The standard culture method detected a single pathogen in 47.1% of cases. BFPP showed a sensitivity of 93.9% and a specificity of 45.9% for the total sample. The performance of BFPP in detecting antimicrobial resistance genes varied for different pathogens with overall sensitivity of 40.1% and specificity of 95.9%. Conclusion: The Biofire Pneumonia Panel (BFPP) demonstrated high sensitivity for several bacterial pathogens, indicating its potential as a rapid diagnostic tool. However, its performance varied for different microorganisms, and it had limitations in detecting certain pathogens and antimicrobial resistance genes for which still required more further studies to explore different resistance gene mechanism that can be incorporated in this panel in future. The BFPP can complement standard culture methods as a rapid tool in the diagnosis of LRTIs
Correlation of Point-of-Care Lung Ultrasound Scoring System with Clinical Score and Chest X-ray Score for Newborns with Respiratory Distress
(PUBMED, 2025-07-07) Brajendra Singh; Chinmay Chetan; Saikat Patra; Girish Gupta; Vinayak Madhukar Jedhe; Shoham Majumder
Objectives To determine correlation between the lung ultrasound score with the chest X-ray score and the Downes score in neonates with respiratory distress. Methods All consecutive neonates admitted in the neonatal intensive care unit (NICU) with respiratory distress were checked for eligibility at admission. Clinical scoring was done using Downes score immediately. 12 area lung ultrasound scoring was done using Brat Score by trained experts. Chest X-ray scoring was done from high quality anteroposterior images. The findings of the three scores were then compared and correlated using Pearson correlation coefficient. Results One hundred neonates were enrolled with mean gestational age of 34.8 ± 3.6 wk and mean birth weight of 2063.7 ± 722 g. A positive correlation was found between Downes score and lung ultrasound score (Pearson correlation coefficient 0.712, p-value < 0.001) but not between lung ultrasound score and chest X-ray score. In the subgroup analysis, a statistically significant correlation was found between lung ultrasound score and Downes score for babies > 32 wk gestation but not for those < 32 wk gestation. Conclusions In neonates admitted to NICU with respiratory distress, lung ultrasound score correlates well with Downes score, especially in babies with gestational age > 32 wk.
Designing and assessing the impact of a competency-based training program in transfusion medicine among MBBS interns
(SCOPUS, 2025) Manish Raturi; Yashaswi Dhiman; Naveen Bansal; Basanta Khatiwada; Dushyant Singh Gaur; Poonam Rawat
Introduction: It has been widely recognized that there is a pressing need to strengthen transfusion medicine education for both undergraduate and postgraduate medical trainees across various clinical specialties to enhance patient safety. In response to this, the National Medical Commission (NMC) of India implemented a competency-based medical education (CBME) framework in 2019 for undergraduate MBBS students across all medical colleges in the country. The present study aimed to assess the impact of a training program designed for medical interns, developed in alignment with the CBME curriculum prescribed by the NMC. Materials and methods: This was a questionnaire-based cross-sectional study conducted among MBBS interns undergoing rotatory training in different departments of a tertiary care teaching hospital. A structured two day educational program was organized, comprising six modules—three focusing on bedside transfusion practices and three addressing blood donation and laboratory-based transfusion medicine. Each module was designed to reflect the competencies outlined in the CBME curriculum and included pre- and post-training assessments to evaluate knowledge improvement. A pre-test was conducted to assess the knowledge of transfusion medicine among the participants and the post-test was conducted to assess the impact of the training program. Results: Overall, the pre-test score in the present study was 14.1 (47%) which increased to 22.3 (77.6%) in the post-test. Analysis of the pre-test scores showed that 80% of the interns had weak knowledge of blood transfusion reactions and its management. 55.6% of the interns had weak knowledge of indications of blood component therapy whereas 32.2% of the interns had weak knowledge of bedside transfusion medicine practices. 73.3% of the interns had weak knowledge of blood donor selection and counselling. 62.3% of the interns and 73.3% of the interns had weak knowledge of transfusion transmitted infections and basic blood banking including compatibility testing and storage conditions for various blood components, respectively. Post-training results showed a significant improvement across all domains. Effect size analysis using Cohen’s d indicated that the training program was highly effective in five out of six domains, with moderate effectiveness observed in the domain of immunohematology. Conclusion: Although transfusion medicine knowledge is essential for routine practice in core medical and surgical specialties, a substantial knowledge gap exists among medical interns. This study demonstrates that a structured, CBME program is an effective strategy to improve transfusion medicine knowledge among MBBS interns
Diagnostic Utility of Fine Needle Aspiration Cytology in a Case of Pulmonary Hydatid Cyst Masquerading as Tuberculosis
(PUBMED, 2025) Smita Chandra; Akanksha Aggarwal; Varuna Jethani
Hydatid cyst may mimic other diseases including carcinoma and tuberculosis which may raise diagnostic dilemma that may be more enhanced in areas where tuberculosis is endemic. This may result in delayed diagnosis of hydatid cyst leading to its complications. The present case is therefore being reported as it was clinically and radiologically diagnosed as tuberculosis but on fine needle aspiration cytology (FNAC) turned out to be a case of hydatid cyst. In addition, vigilant cytological examination revealed only protoscolices and hooklets instead of laminated cyst membrane which is more commonly and easily observed. FNAC serves as a valuable adjunctive tool in the diagnosis of hydatid cysts providing rapid and accurate diagnosis that can guide clinical management and improve patient outcome.
Double BCG vaccination in a neonate: implications, management and prevention
(PUBMED, 2023-12-01) Chinmay Chetan; Saikat Patra; Shailendra Kumar Singh; Girish Gupta
Tuberculosis is a common cause of morbidity and mortality especially in low-income and middle-income countries like India. BCG vaccination is recommended for all neonates after birth in areas with a high tuberculosis disease burden. Here, we describe a case where a neonate received two doses of the BCG (Chennai strain) vaccine within a span of 4 days after birth due to a vaccination error. Parents were informed about the event. The infant was managed conservatively and followed up till 12 months of life for any possible complication. There were no serious adverse effects apart from the localised reaction and a double scar on the left arm. Measures to avoid any such error in the future and the need for reporting medication error has been highlighted. Parental concerns are frequent in such scenarios and should be actively addressed.
Dual fluid silhouette in X-ray of the abdomen: a diagnostic flag for neurogenic bladder with urinary ascites
(PUBMED, 2024-06-04) Brajendra Singh; Chinmay Chetan; Aisha Naaz; Girish Gupta
A neonate presented with abdominal distension and decreased urinary output. X-ray revealed dual abdominal fluid condition-ascites with a distended bladder, along with vertebral anomalies. The possibility of urinary ascites and neurogenic bladder was kept, which was further confirmed on evaluation. Here, we emphasise the crucial role of abdominal X-ray as a diagnostic tool in uncovering this intricate medical puzzle. By detailing the clinical presentation, diagnostic approach and treatment strategy, the report contributes insights into the rare and complex abdominal condition.
Duplicated Ureter: A Rare Anatomical Variation Diagnosed Incidentally During Open Radical Hysterectomy for Carcinoma Endometrium and Avoidance of Mishappening: A Case Report
(Springer, 2024-04-24) Shivangi Sundram; Sourabh Nandi
This case report presents a rare anatomical variation known as double ureter, where a comprehensive unilateral duplication of the left ureter originating from a single renal tissue was incidentally discovered during staging laparotomy for CA endometrium. This congenital anomaly significantly heightens the possibility of unintentional damage to the ureter during surgeries involving the pelvic area. In summary, ensuring careful exposure of both ureters along with the continuous vigilance of surgeons remains pivotal for ensuring a secure surgical procedure.
Effect of Recorded Chants of the “OM” Mantra as an Interventional Music Therapy on Reducing Stress in Newborns Admitted to the Neonatal Intensive Care Unit: An Observational Study
(SAGE Publications, 2023-05-31) Shailendra Kumar Singh; Saikat Patra; Chinmay Chetan; Girish Gupta
Introduction Newborns admitted to the neonatal intensive care unit (NICU) are under tremendous stress. The “OM” sound is known to have a calming effect on adults. The effect of administering chants of “OM” to newborns is unknown. Objectives Primary Objective To evaluate the effect of the “OM” sound on vital parameters in newborns admitted to the NICU. Secondary Objectives To observe the duration of the effect of the “OM” sound on vital parameters after the music therapy and to observe its effect at various gestational ages. Methods Prospective observational study was carried out over 4 months. 57 newborns enrolled were administered music therapy by playing recorded chants of “OM” mantra (MTOM). Vitals were recorded before, during, and after MTOM. Results The heart rate (HR) before and with MTOM was 142 ± 7 and 130 ± 11 bpm (p = .001). The decrease in HR persisted even after 1 h of stoppage of MTOM (p = .001). A significant decrease in HR was observed in all gestations (p = .001). There was no significant difference in respiratory rate (RR) and SpO2 before and with MTOM. Conclusion MTOM significantly reduces HR in newborns of all gestational ages, and its effect persists for at least 1 h after stopping MTOM.
Effectiveness of Probiotics and Phototherapy Compared to Phototherapy Alone in Treating Hyperbilirubinemia in Neonates ≥35 Weeks Gestation: A Comparative Observational Study
(SCOPUS, 2023-06-01) Suraj Kumar Singh; Girish Gupta; Sanober Wasim; Rakesh Kumar; Saikat Patra; Chetan Chinmay
Introduction Neonatal jaundice is a common condition in neonatal practice. Phototherapy is accepted first line of therapy in its treatment. Probiotics can be an addition as it decreases enterohepatic circulation and improves gut function. Materials and Methods The observational study was conducted in 40 neonates. Participants were divided into 2 groups, phototherapy alone (PA) and probiotics plus phototherapy (PP). The mean difference in total serum bilirubin (mg/dL) levels, total duration of phototherapy, incidence of rebound hyperbilirubinemia, frequency of stooling after initiation of therapy, feed intolerance, and occurrence of new onset sepsis was compared. Results The mean difference in serum bilirubin level was not statistically significant after 12 hours (p = .321), 24 hours (p = .544) and 48 hours (p = .863) after initiation of phototherapy. An increase in frequency of stool in the first 24 hours was observed in PP group (p = .003). The total duration of phototherapy was less in PP group although not statistically significant (25 hours vs 38 hours, p = .054). Rebound hyperbilirubinemia was significantly higher in PA (p = .023). There were no cases of feed intolerance and sepsis. Conclusion The addition of probiotics did not alter the clinical course of jaundice. However, probiotics can reduce the rebound hyperbilirubinemia and is safe as it did not increase incidence of new onset sepsis or feed intolerance.
Elizabethkingia meningoseptica With Targeted Environmental Surveillance in a Tertiary Care Hospital: A Retrospective Cohort Study
(PUBMED, 2025-01-07) Garima Mittal; Rajender Singh; Manish Mittal; Mani Pant; Barnali Kakati; Saikat Patra
Introduction Elizabethkingia meningoseptica (E. meningoseptica) is a multidrug-resistant, non-fermenting Gram-negative bacillus increasingly associated with nosocomial infections, particularly in immunocompromised and critically ill patients. Its intrinsic resistance to multiple antibiotics limits treatment options and contributes to adverse clinical outcomes. Aim and objective The study aimed to investigate the clinical and microbiological characteristics of E. meningoseptica infections among ICU/NICU patients and to explore potential environmental sources through hospital-based surveillance. The objectives of this study were to describe the clinical and demographic profiles of ICU/NICU patients with E. meningoseptica infection; to assess the associated risk factors contributing to these infections; to analyze the antimicrobial susceptibility patterns of the isolated strains using standardized microbiological methods; to evaluate treatment outcomes including morbidity, mortality, and duration of ICU/NICU stay; and to identify potential environmental reservoirs of E. meningoseptica through surveillance activities coordinated by the Hospital Infection Control Committee (HICC). Methods A retrospective cohort study was conducted over 18 months (July 2023 to October 2024) at a tertiary care hospital. A total of 15 patients with culture-confirmed E. meningoseptica infection were included. Demographic, clinical, microbiological, and treatment data were collected. Identification and antimicrobial susceptibility testing were performed using the Vitek-2 automated identification system (bioMérieux, Marcy-l'Étoile, France). HICC conducted routine and targeted environmental sampling as per policy protocol. Results Among the 15 patients with E. meningoseptica infection, nine (60.0%) were adults, and 11 (73.3%) were male individuals. Sepsis was reported in nine (60.0%), and both ventilator-associated pneumonia and septic shock occurred in six patients each (40.0%). Hypertension and diabetes mellitus were present in six (40.0%) and three (20.0%) patients, respectively. Two neonates (13.3%) with low birth weight and prematurity required NICU admission. Outcomes included mortality in six patients (40.0%), discharge in five (33.3%), and four (26.7%) leaving against medical advice. Endotracheal secretions were the most frequent specimen (46.7%), followed by tracheostomy secretions (33.3%) and blood cultures (13.3%). All isolates (100%) were resistant to carbapenems, third-generation cephalosporins, aztreonam, and piperacillin-tazobactam. Resistance to gentamicin, colistin, and cotrimoxazole was observed in 73.3%, 66.7%, and 46.7% of isolates, respectively. Highest susceptibility was seen with minocycline (66.7%), vancomycin (60.0%), and fluoroquinolones (53.3%). Environmental surveillance, conducted from January to March 2023 as part of routine as well as targeted HICC monitoring (as an outbreak of suspected pathogens was suspected from the NICU and ICU), included 98 samples from high-risk ICU/NICU sites such as sinks, ventilators, humidifiers, and suction units. E. meningoseptica was identified in one sample (1.02%), isolated from a NICU sink. Conclusion E. meningoseptica infections are associated with high resistance and mortality. Minocycline, vancomycin, and fluoroquinolones may be effective. Early detection, targeted therapy, and HICC-led surveillance are essential for control.
Evaluating the influence of a psychiatry training program on nursing students’ attitudes towards mentally ill
(PUBMED, 2025-07-04) Praveen Rikhari; Vishal Sinha; Gyanendra Kumar; Ayushi Bisht; Aayush Kapoor; Pragya Rikhari
BACKGROUND: Mental disorders are a global concern, affecting millions worldwide. Despite effective therapies, societal stigma toward mental illness persists, hindering access to healthcare and perpetuating negative stereotypes. These prejudiced attitudes are also present in nursing professionals and impact the quality of care provided by them. This study aimed to explore the impact of a month‑long residential psychiatry training program on the attitudes of nursing undergraduate students toward mental illness. MATERIALS AND METHODS: This was a longitudinal study with pre‑post design conducted at a government mental health hospital and training institute in north India using convenient sampling. The Community Attitude Towards Mental Illness (CAMI) Scale, which has subscales of Authoritarianism, Benevolence, Social Restrictiveness, and Community Mental Health Ideology was used to measure the attitudes towards the mentally ill in nursing students before and after the training program. Descriptive statistics were used to present the data while paired t‑tests and McNemar test were used for analysis. RESULTS: A total of 970 students were included. A significant improvement in Social Restrictiveness, Community Mental Health Ideology, and the total CAMI score was noted post‑training (P < 0.001 for each) while changes in Authoritarianism (P = 0.87) and Benevolence (P = 0.1) were nonsignificant but positive. Furthermore, increased willingness to work in psychiatry wards post‑training was found, indicating a positive influence on career choices (P < 0.001). CONCLUSIONS: The results emphasize the effectiveness of combining theoretical knowledge with real‑life exposure in mental health nursing. Despite limitations, like a single‑center study and no control group, the study’s pre‑post design and large sample size contribute valuable insights.
Extracerebral choroid plexus papilloma in a newborn: a rare presentation
(PUBMED, 2023) Santosh Kumar Singh; Saikat Patra; Nadia Shirazi; Girish Gupta
Choroid plexus papillomas (CPPs) are extremely rare lesions that originate in the central nervous system. Still rarely, these can occur in heterotopic locations. We report a case of aneonate who presented at fourth week of life with a small swelling in the left side of the oropharynx. There were no other symptoms. MRI scan revealed a cystic lesion with the possibility of lymphatic malformation or teratoma. Swelling which was gradually increasing in size was electively excised. Histopathological examination revealed it to be an extracerebral CPP. Postoperative period was uneventful, and baby had no further complications. CPP is a rare lesion and, almost always, cannot be anticipated before surgery. Imaging only helps in surgical planning. Complete excision is curative.
Facial Scalds due to Steam Inhalation in a Neonate – A Case Report
(Journal of Nepal Paediatric Society, 2024-08-01) Chinmay Chetan; Saikat Patra; Aisha Naaz; Girish Gupta
Steam inhalation is a traditional remedy used in all age groups for treating respiratory problems like cough, coryza, pharyngitis, bronchiolitis, etc. Though equivocally beneficial, should be avoided in neonates, due to the risk of burns if not used correctly. We present a case of a term neonate with scalds on his face due to steam inhalation, given by his mother, to treat cough and coryza. First and second-degree burns were present on the face. Oral, nasal cavities, and eyes were unaffected. This case highlights the probable side effects of steam inhalation, a therapeutic approach lacking proven advantages. This reemphasizes the need to avoid such treatment strategy, especially in neonates who are predisposed to such injuries.