Background: Peripheral venous cannulation (PVC) is one of the commonest procedures carried out in hospital.  It allows rapid and accurate administration of medication. However, there is dearth of formal training to nurses There are few studies which has shown benefits of offering formal training to improve clinical practice and patient care.Methods: In view of rising cases of thrombophlebitis, nurses were trained in hand hygiene, patient skin preparation, wearing gloves and aprons, establishing a clean environmental field, using sterile equipment, disposing of contaminated or soiled equipment and linen appropriately, safe disposal of sharps and adherence to universal precautions. Retrospective, observational, single centre study to analyse data of inpatients for 4 years duration was carried out.  This included 2 years data prior to offering nursing training and 2 years post training.Results: There is statistically significant improvement in number of thrombophlebitis event for 2 years prior and 2 years post training.  Total events in 2 years prior to training were 63 which reduced to 22 in later 2 years due to nursing training. A p value was 0.0297. Out of total 87 thrombophlebitis incidences, 40 and 47 incidences in males and females respectively were observed. Mean age for men was 58.39 and mean age for female was 52.62 with SD 27.39 and 22.06 respectively.Conclusions: When nurses were trained in patient assessment, Insertion site selection (prefer hand and forearm; to avoid joints and lower limbs), catheter selection, dwell time, early identification of phlebitis and appropriate corrective measures and compliance with best practice guideline, thrombophlebitis rates drastically reduced.

Background: This study presents the outcome of integrated treatment approach based on government mandated standard allopathic treatment along with alternatives in COVID-19 patients. The aim of our study was to investigate the outcome of treatment strategy, co-morbid status, recovery and mortality rate of COVID-19 patients at Bhaktivedanta Hospital and Research Institute. Methods: Post ethics committee approval for multiple centers, data for 1049 COVID-19 patients (RTPCR confirmed cases) of all age groups and genders which were admitted in a dedicated covid hospital from March 2020 to November 2020 was analysed retrospectively. Results: This study highlights the management of COVID-19 patients with an integrated approach. In our cohort with 36.7%, 44.70 %, 18.58% of mild, moderate and severe cases respectively, mortality rate was only 3.43% of total positive patients admitted at our hospital. Conclusions: We emphasize that even in healthcare facilities with limited resource and poor infrastructure and lack of ICU facilities, clinical observation-based management can help to reduce mortality considerably. Unique features of our study include use of progesterone as an immune modulator, use of dual antiviral agents and use of age-related lower limit of oxygen saturation.

Background: The characterization of intensive care unit (ICU) admitted COVID-19 patients with co-morbid conditions requiring ventilator support can help investigators worldwide to prepare for emergency situation arising at the time of spread of disease. The objective of our study is to analyse the outcome of ICU admitted COVID-19 patients with co-morbid conditions. Methods: Post ethics committee approval for multiple centers, data of 212 consecutive discharged and death COVID-19 confirmed ICU patients were included and analyzed. These patients of all age groups and genders were admitted in Bhaktivedanta Hospital and Research Institute, Mira Road, Mumbai, Maharashtra, India which is a dedicated COVID hospital from March 2020 to November 2020. Results: Of the total 212 ICU patients, 17 (9%) cases were moderate, 195 (91%) were severe cases as per CT severity score grading, median duration of stay in the hospital was 9 (37%) days. Diabetes mellitus was the leading co-morbid condition with frequency of 27.8% followed by ischemic heart disease (IHD) (5.6%), chronic kidney disease (CKD) (5.1%), asthma (3.77%) and chronic obstructive pulmonary disorder (COPD) (0.94%). Conclusions: Not all patients with co-morbid conditions progress towards poor lung function. IHD is the worst prognostic indicator for progressing towards poor lung function as compared to diabetes, CKD and COPD.

Background: Asterion Introduction: Enteric fever is a major concern in developing country. It is predominantly caused by serovars typhi and paratyphi of Salmonella enterica. Recently, an upsurge in antimicrobial resistant strains has worsened the management of enteric fever. So, aim of present study is to evaluate the clinical profile, antibiotic sensitivity and prescription pattern in blood culture proven cases of enteric fever in pediatric and adult patients.Methods: Single centre, prospective study was conducted at a tertiary care hospital. Demographic and clinical details of blood culture proven enteric fever admitted in hospital were collected over the period from August 2016 to November 2018.Results: Total 58 blood cultures grew Salmonella spp. , amongst them 84.48 % had growth of Salmonella typhi. Blood culture was sent after a mean period of 9 days and 10 days of fever in pediatric and adult patients respectively. All isolates of S. paratyphi A were pansusceptible, whereas 36.73 % isolates of S. typhi were multidrug resistant and nalidixic acid resistant. 68.97% patients received antibiotics before admission. The difference between mean time to defervescence in patients who received ceftriaxone and those who received more than one antibiotic was not statistically significant. (P value 0.87)Conclusion: Blood cultures are the important diagnostic tool to identify multidrug resistant Salmonellae. Study showed that combination therapy was not statistically superior and awareness of local antimicrobial susceptibility pattern significantly helps for better management of the patients.