Background:The current standard followed for assessing central venous catheter (CVC) tip placement location is through radiological confirmation using chest X-ray (CXR). Placement of CVCs under electrocardiogram (ECG) guidance may save cost and time compared to CXR.Objective:The objective of this study is to compare the accurate placement of the CVC tip using anatomical landmark technique with ECG-guided technique. Another objective is to compare CVC placement time and postprocedural complications between the two techniques.Methods and Materials:A total of 144 adult individuals, who were critically ill and required CVC placement in the Emergency Department, were included for the study. Study duration was 6 months. Anatomical landmark and ECG-guided groups were assigned 72 participants each. Analyses were performed using t and Chi square-tests.Results:It was observed that 13 (18%) in the landmark technique were malpositioned as compared to none in the ECG-guided technique (P = 0.000). The landmark group had 22 (30.6%) participants with arrhythmias during the procedure, compared to none in the ECG-guided group (P = 0.000). The landmark group revealed that 30 (41.7%) of the CVC were overinserted and required immediate repositioning, compared to none in the ECG-guided group (P = 0.000).Conclusion:ECG-guided technique was found to be more accurate for CVC tip placement than the anatomical landmark technique. Furthermore, the ECG-guided technique was more time-effective and had less complications than the anatomical landmark technique. Hence, ECG-guided CVC placement is relatively accurate, efficient, and safe and can be considered as an alternative method to conventional radiography for confirmation of CVC tip placement.

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Background: Peripheral intravascular cannulas are indispensable in modern day medical care. These cannulas, if not inserted properly, predispose a patient to various morbidities. The present study was carried out to assess the incidence of intravascular cannula associated infections and correlate it with cannula insertion techniques and ward practices. Methods: The study was carried out in the wards of a tertiary care hospital. The study was divided into two phases, each phase comprising of 50 patients. In phase 1, cannula insertion was carried out after normal ward cleaning practices. In phase 2, cleaning of the site was done by standard surgical cleaning procedure. The cannula samples after removal were cultured and local signs of thrombophlebitis looked for at the site of insertion. Thrombophlebitis was considered a surrogate marker of local infection in the vessel wall. Result: The relative risk of acquiring thrombophlebitis increased by 2.18 times (applying univariate analysis) by existing methods as compared to the standard method. Conclusion: Use of standard cleaning protocol had a significant effect on decreasing the incidence of cannula associated infections and cannula related morbidity. MJAFI 2010; 66 : 113-116

Background:The effect of larger and distal environmental and societal factors on oral health is established and the concept of social capital (SC) is gaining importance.Aim:The aim of the study is to evaluate the association of dental caries (DC) experience of children with parental social SC.Methods:A cross-sectional survey was conducted among 200 pairs of 5–12-year-old children and their parents of Kaloor (65th division), Kerala. A 30-item self-administered neighborhood SC Index questionnaire. DC of children was assessed as per the WHO guidelines.Results:The final analysis included 186 pairs of children and parents, out of which 54.8% were boys. The mean caries experience of children was 3.3 ± 3.7. A significantly higher proportion of parents rated their children as “poor oral health” in caries experienced group than caries-free group (P = 0.006). No other significant differences were found with total SC and demographic variables except for “frequency of having meal together.” Regression analysis showed that trust, control, and political domains were significant with carious status. On adjusting the confounders that were significant in bivariate analysis, only control domain of the SC remained significant.Conclusion:The social control domain (family members or neighbors actions that seek to correct deviant behavior) of SC was associated with caries experience of the children. Distal factors such as SC can influence the caries status of children.

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