Anu Bhardwaj

A cross-sectional study of the knowledge, attitude, and practice of general practitioners regarding dog bite management in nothern India

Context: There are many myths and false beliefs associated with wound management. These include application of oils, herbs, and red chilies on wound inflicted by rabid animals, and not washing the wound properly. General practitioners (GPs) constitute a key source of medical care in study area and are approached for anti-rabies treatment by victims of animal bites. Aim: The aim of the present study is to assess the knowledge and practices among the general practitioners (GPs) regarding dog bite management. Settings and Design : Community-based cross-sectional study. Materials and Methods: The present study was carried out in the private and public clinics of Ambala city from January 2012 to April 2012 using a pre-tested self-administered questionnaire. The study population composed of 100 GPs comprising 45 MBBS or above degree holders (Group 1) and 55 other GPs like BAMS, RMPs, etc (Group 2). Statistical Analysis Used: Interpretation of data was done using percentages and proportions. χ2 -Test was used to test the statistical difference in the knowledge between the two groups. Results: Out of the total, 68% and 29% respondents in Group 1 and Group 2, respectively, correctly told that wound must be washed with soap and water for minimum period of 15 min. A total 71% and 11% respondents in Group 1 and Group 2, respectively, could correctly answer about the target groups for pre-exposure prophylaxis. A total 62% GPs did not know the high-risk groups to whom pre-exposure prophylaxis has to be given. Conclusions: There was an apparent lack of awareness among the GPs regarding appropriate animal wound management and vaccine administration. Reorientation programs and continued medical education for GPs are required to highlight the WHO guidelines regarding treatment of animal bite.

A cross sectional study of the patient's awareness and understanding toward legal nature of informed consent in a dental hospital in rural Haryana

Aims: The objective of this study is to define the patients awareness of legal issues, attitude toward consent process. An additional objective of this study is to find out whether or not the patients actually understand what has been explained to them. Materials and Methods: The present cross-sectional study was carried out during January 2011 to July 2011 at a tertiary care dental hospital. In this study, a structured interview schedule was developed and handed out to 582 patients in the various outpatient departments of the hospital. SPSS version 11.5 was used for analysis. Results: Of the 582 patients approached, 58 patients refused to participate and interviewed 524 patients. Most (88.0%) of the patients under study thought that they had no right to change their minds after signing the consent. A total of 75% patients falsely believed that it was a legal requirement. Overall the level of understanding was poor in 17%, unsatisfactory in 33%, satisfactory in 32%, and good in 18% of the patients. The level of understanding was significantly associated with educational level ( P Conclusion: There exists a vast discrepancy between the informed consents perceived by patients. Limited knowledge of the legal implications of signing or not signing consent form indicates that consent process should be reassessed in order to achieve patient autonomy.

Perceptions of relatives toward medico-legal investigation and forensic autopsy: A cross-sectional survey from rural Haryana

Background: Currently, a greater emphasis is being placed on the active participation of patients and their families; it is time that the attitude and feelings of the families with regard to autopsies are investigated. Objectives: Therefore, the present study was planned with an objective to analyze and ascertain deceased family member’s attitudes toward medico-legal investigation and forensic autopsy. An additional objective was to determine factors influencing autopsy refusal by relatives of the deceased. Materials and Methods: Two hundred family members or relatives were selected randomly from the list of address and contact number prepared from all the cases on whom autopsy was performed from 2010 to 2012 at the MM Institute of Medical Sciences. Results: Data of 165 deceased personnel were processed and analyszd. 30.9% of the respondents had a primary level of education while 35.2% of them were illiterates. A high proportion of study subjects considered that autopsy would result in visible disfigurement of the body. Involvement of police/court (92.1%), no use in knowing the cause of death/nature of death (88.6%) and autopsy delays funeral (83.4%) were the three top most causes responsible for autopsy refusal by family members or relatives of the deceased. Conclusion: The experience and opinions of relatives and family members can be utilized in more effective management of medico-legal cases.

Current status of timing of treatment interruption and pattern of default among tuberculosis patients on directly observed treatment

Background: Default remains an important challenge and a threat for tuberculosis (TB) control. Aims and Objectives: Objectives of the study were to analyze timing of treatment interruption and pattern of default among TB patients on directly observed treatment, short-course under Revised National Tuberculosis Control Programme. Materials and Methods: The present cross sectional study was conducted among the cohort of patients registered during January 2011 to September 2011 at the Tuberculosis Unit, Ambala city. Number of interruptions/doses missed, number, and timing of default were taken from TB register and treatment cards. Results: Out of 80 defaulters, majority (50,62.5%) defaulted in the continuation phase of treatment. Out of these 50 patients, 31 were new and remaining 19 were from previously treated categories. In category I, maximum default was seen in the third month of treatment ( 2.84%). The cumulative default rate at the end of second month was 2.57%. The default rate at the end of the eighth month, when all patients were censored, was 8.18%. In category II, maximum default (3.61%) occurred in the fourth month. The cumulative default rate by the end of third month was 13.92%; and by the end of eighth month, 21.76%. The default rate by the end of the tenth month, by which time all patients were censored, was 21.76%. Conclusions: Patient defaulting from treatment remains a matter of concern. Factors behind higher default rate in continuation phase need to be explored. Default in intensive phase of treatment and without smear conversion at the end of intensive phase should be retrieved on a priority basis.