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Biomedical subjects

I Madan

Publications and source records attributed to I Madan.

16 recordsLinked to original sources
PubMed2002

Out of hours management of occupational exposures to blood and body fluids in healthcare staff.

AIMS: To assess and compare the out of hours and in hours management of occupational blood and body fluid exposures in a London teaching hospital. METHODS: The occupational health and accident and emergency records of individuals presenting with occupational body fluid exposures over a six month period at a London teaching hospital were analysed retrospectively. Main outcome measures were the completeness of records, and the appropriate management of body fluid exposures using the Department of Health guidelines as the gold standard. RESULTS: A total of 177 body fluid exposures were reported; 109 (61.58%) were initially assessed in the occupational health department, and 68 (38.42%) in the accident and emergency department. Of those originally assessed in the accident and emergency department, only 21 (30.88%) attended the occupational health department for follow up. Occupational health staff were more consistent in assessing and managing exposures, and in a higher proportion of cases gave more appropriate advice on post-exposure prophylaxis (PEP) against hepatitis B and HIV. Of the 11 individuals prescribed HIV PEP (all by accident and emergency staff), only three subsequently attended occupational health for follow up. In all three cases therapy was discontinued, as the source was HIV negative or the exposure low risk. CONCLUSIONS: Out of hours management of occupational body fluid exposures, particularly the prescribing of HIV PEP, was inconsistent with in hours practice. This may also be the case in other large inner city hospitals offering a similar service.

Blood↗
PubMed2002

"Cariogenic potential of homemade weaning diet v/s commercial formula feeds" an in-vitro study.

The universal phenomenon of introducing weaning diet to the growing child sets its onset by the age of 4-6 months. This preliminary diet of the child governs his or her dental health in the long run. The main objective of this study is to investigate the histopathological and clinical invasion of deciduous teeth exposed to both the homemade weaning diet and commercial formula feeds. The study also aims at motivating the consumption of the most appropriate diet for the weaning baby. Extracted deciduous teeth were incubated with the test solutions of homemade diet and commercial formula feeds for the period of 6 weeks. Fewer carious invasion both clinically and histopathologically were seen in homemade feeds. Thus, homemade diet can be a strong candidate for the status of 'THE IDEAL WEANING FOOD'.

Animals↗
PubMed2000

Methicillin-resistant Staphylococcus aureus and multidrug resistant tuberculosis: Part 1.

The first of these articles reviews the epidemiology of MRSA and its clinical importance in a healthcare setting. The methods of controlling the spread of hospital acquired MRSA are discussed with an emphasis on the role of screening staff for MRSA. Relevant papers for the review were identified by a systematic literature search on Medline. The prevalence of MRSA is increasing in the United Kingdom, as is the prevalence of 'epidemic' MRSA strains. Several countries have recently reported cases of Staphylococcus aureus with intermediate-level resistance to vancomycin. The key measures to minimizing hospital-acquired MRSA are stringent infection control programmes and strict antibiotic policies. Staff screening should only be undertaken after a detailed risk assessment of the local situation has been made by the occupational health and infection control teams. Priority should be given to high-risk areas of a hospital where MRSA is endemic.

Drug Resistance, Multiple↗
PubMed2000

Methicillin-resistant Staphylococcus aureus and multidrug resistant tuberculosis: Part 2.

Drug resistant tuberculosis has been recognized since chemotherapy first became available. However, drug resistance has increased in many countries, and recently strains resistant to both rifampicin and isoniazid (multidrug resistant tuberculosis) have emerged. This review discusses the epidemiology of multidrug resistant tuberculosis (MDRTB), and the control of MDRTB in healthcare facilities. Relevant papers for this review were identified by a systematic literature search on Medline. MDRTB is already established world-wide, and although the overall problem of resistance remains low in the UK, it is of significant clinical importance due to its high case-fatality, higher transmission risk, and complex treatment. The key elements of MDRTB control are prompt recognition, confirmation and treatment of cases, and the institution of strict infection control procedures to reduce the airborne spread of infection from infectious patients to others. This review emphasizes the importance of a multidisciplinary approach to management, with liaison between tuberculosis physicians, the microbiology department, infection control team, consultant in communicable disease, and occupational health.

Antibiotics, Antitubercular↗
PubMed1997

Audit of a pre-employment risk identification form.

A risk identification form was introduced as part of Southmead Health Services NHS Trust's pre-employment procedure. Its purpose was to allow occupational health nurses to identify employees with specific occupational health needs. One hundred employees' risk identification forms were studied and a comparison made between the manager's assessment and that of an independent occupational health nurse's assessment based on job title alone. The actual risks involved in the post were identified by the employee after 1 month employment, together with an occupational health nurse from Southmead NHS Trust. There was a greater agreement between the managers' assessments and the actual risks identified (range 83-100%), than between the independent nurse's assessments and the actual risks identified (range 59-100%), in all categories other than driving. The sensitivity of the managers' risk assessments were higher than that of the independent nurse in all categories and the positive predictive value of the managers' risk assessments were higher than that of the independent nurse in all but two categories.

England↗
PubMed1997

Contamination incidents among doctors and midwives: reasons for non-reporting and knowledge of risks.

A 6-month retrospective self-administered questionnaire study of 482 doctors and 380 midwives in two NHS Trusts was undertaken. The response rate was 384 (80%) and 293 (77%) respectively. The study revealed that only nine per cent of doctors and 46% of midwives had reported the contamination incidents they had received. The doctors' main reason for non-reporting was 'too time consuming' and midwives' was 'did not consider anything could be done', although their awareness of the active management of contamination incidents by occupational health departments was good. Seventy-seven per cent of doctors and 69% of midwives underestimated the risk of contracting hepatitis B virus from a needlestick injury, whilst 52% of doctors and 36% of midwives underestimated the risks of acquiring infection with HIV (human immunodeficiency virus) infection following such an injury. Strategies for improving the knowledge of the potential risks of contamination incidents and methods for facilitating ease of reporting are discussed.

Attitude of Health Personnel↗
PubMed1993

Expired air temperature at the mouth during a maximal forced expiratory manoeuvre.

We have studied the temperature of expired air during a maximal forced expiratory manoeuvre, because this has not previously been fully investigated and it will influence how flow and volume recording devices should be calibrated and used. Temperature was recorded with a fine thermocouple, the response time of which was determined at various gas velocities and for which a correction was made. Recordings during maximal forced expiratory manoeuvres were made on 12 normal subjects and 12 subjects with chronic airflow limitation. The thermocouple was placed in the mouthpiece, so that it was at the level of the lips during a blow. In the normal subjects, the effect of differing inhalation protocols was also determined. In the normal subjects, the mean temperature was 33.6 degrees C at peak expiratory flow (PEF), and 34.4 degrees C at 75% forced vital capacity (FVC), but fell to 33.4 degrees C at FVC. In the subjects with chronic airflow limitation, the temperature was constant at 35.0 degrees C from PEF up to 50% FVC, being significantly higher than in the normals, and fell to 33.5 degrees C at FVC. Expired air temperature up to 50% FVC was significantly negatively correlated with absolute PEF, forced expiratory volume in one second (FEV1) and FVC. In the normals, a slow inhalation through the nose raised the expired temperature by almost 1 degree C throughout the blow, whereas inhaling air at 6 degrees C did not affect expired air temperature. The expired air temperature can vary by up to 3 degrees C between individual subjects, and it is influenced by the route of inhalation and the inspired volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Prevalence of cryptosporidiosis in Dammam and Alkhobar, Saudi Arabia.

This report presents results from a 6-month study over the period 16 November 1986 to 15 May 1987 which was designed to investigate the prevalence of cryptosporidiosis in Dammam and Alkhobar, Saudi Arabia. A total of 209 stool specimens from children and 112 from adults with diarrhoea were examined. Only two (1%) of the children, both aged 2 years, were positive for Cryptosporidium spp. Giardia lamblia was found in 13 (4%) cases and was found to be the most common protozoan parasite, whereas Salmonella spp. was seen in 19 (6%) cases. Stool specimens were examined for rotavirus from children under 2 years of age; 31 (41%) of the specimens were positive.

Adult↗