Journal of Surgical Specialties and Rural Practice

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Background: There is the scarcity of population-based studies on knowledge, attitude, and practice (KAP) about COVID-19 in Tamil Nadu and no literature on the rural-urban differences in KAP about COVID-19 in Tamil Nadu. Aims and Objectives: The study was conducted with the primary objective of estimating KAP regarding SARS-COV2 virus in Tamil Nadu and secondary objectives of determining the rural-urban differences in KAP and identifying the association between KAP and certain sociodemographic factors. Materials and Methods: An analytical cross-sectional study was done on 305 participants selected from the rural and urban population of Tamil Nadu. Urban data were collected using Google Forms through social media and the rural population data were collected through simple random sampling from three villages in the outskirts of Chennai District. The study tool had ten items to evaluate the knowledge, three items to evaluate the attitude and four items to evaluate the practice regarding COVID-19. Results: The overall KAP scores had a mean of 7.88 out of 10 (78.8%) for correct knowledge, 2.51 out of 3 (83.5%) for positive attitude, and 3.68 out of 4 (92%) for good practice. The knowledge score was slightly higher in the urban region, but the mean practice score (P ≤ 0.001) and attitude score (P < 0.001) were significantly more among the rural population. There was a statistically significant association between higher knowledge score and educational status (P = 0.0000001), male gender and better attitude (P = 0.0052) and higher age (>40 years) and better practice (P = 0.014). Conclusions: The study revealed reasonably good levels of KAP in regard to COVID-19 in Tamil Nadu in both the urban and rural populations.

Background: Acute kidney injury (AKI) is growing as a serious manifestation of multiple etiologies globally. As majority of the admitted patients are in direct contact with nurses, nurses have a pivotal role in the early detection and management of AKI. Nurses must possess knowledge and information about AKI for its early detection and management. Aim: This study aimed to assess knowledge of nurses regarding AKI. Materials and Methods: This cross-sectional descriptive survey was carried out in the emergency department and outpatient departments of selected hospital, New Delhi, over a period of 5 months. Eligibility criteria for inclusion included nurses working in the emergency department and outpatient departments, who can understand or read either English or Hindi language; and were willing to participate in the study. Two hundred and forty-five nurses were recruited as study samples using total enumerative sampling technique. Results: The results of the study revealed that majority 77.1% of the subjects had good knowledge regarding AKI and only 22.9% of participants had poor knowledge regarding AKI. Majority (i.e., 69.4%, 64.1%, 77.1%, and 84.1%) of nurses were familiar with causes of prerenal failure, the various modalities of treatment of AKI, cases that require dialysis, and complications of AKI, respectively. However, only 20.4% of subjects were aware of RIFLE criteria for AKI. Conclusion: The study identified that most of the nurses carry good knowledge regarding AKI, however, still knowledge is lacking in few important aspects pertaining to assessment and management of AKI, which needs to be considered by nursing administrators while planning in-service and continuing education for nurses.

Cholecystostomy tubes are an established treatment option for patients with acute cholecystitis who are considered high risk for cholecystectomy. This is typically done as an interventional radiology procedure through a pigtail catheter inserted percutaneously. A 63-year-old diabetic male presented to our remote Emergency Department in rural North-Western Victoria (Modified Monash Model 4), with severe, stabbing epigastric pain. Despite normal bloods and imaging, the patient became progressively unwell necessitating a diagnostic laparoscopy and open conversion, which revealed acute acalculous gangrenous cholecystitis. A cholecystectomy was attempted and subsequently abandoned as safe dissection within Calot's triangle, without damaging biliary structures, was not possible. Based on the limited available resources at our rural center, a urinary (Foley) catheter was placed in the gallbladder and Hartmann's pouch sutured around it to act as a temporizng cholecystostomy tube while awaiting transfer to a tertiary center. The Foley catheter was removed after 6 weeks with no further intervention required with the patient making a full recovery. Compared to patients in urban areas, rural residents are more likely to experience health-care disadvantages, including increased likelihood to undergo procedures by specialists operating outside of their scope of practice and higher rates of emergency-related intensive care unit admissions. Despite this, and regardless of acuity, specialist availability, or resource distribution, patients will continue to present to rural services with serious medical issues. In such situations and in resource-poor settings, creative solutions are required to temporize ill patients, as we have reported, and represent an important facet of care in a rural setting.

The skill stations are becoming the essential part of undergraduate medical training but availability and uniformity in their structure and functioning are still not universal across institutions. In the absence of cutting edge technology or paraphernalia in newer medical colleges, innovative and creative use of easily available materials to make models for teaching, training, and assessment purpose is highly desirable and attempts should be made by teachers and students both to hone their skills in this regard. A simple intravenous catheterization, which is one of the many essential core skill, is presented here as an example to generate the interest of fellow colleagues.

Background: Pain is a highly deleterious experience for human being during disease condition.Post operative pain of patient is an important concern for health care professional. Aim: The aim of the study was to assess the level of pain and pattern of analgesic practices among patient undergoing orthopedic surgeries and to develop patient tailored analgesic practice. Objectives: The present study objective is to assess the level of pain and pattern of analgesic practices among patient undergoing orthopedic surgeries with a view to develop patient tailored analgesic practice. Materials and Methods: Quantitative research approach with a prospective Observational Design was used for the present study to assess the level of pain and pattern of analgesic practices among patient under going orthopedic surgeries with a view to develop patient tailored analgesic practice in selected orthopedic inpatient department at All India Institute of Medical Sciences, Rishikesh, India.This study consisted of 100 patient undergone orthopedic surgery among them majority (49%) of patient were suffering from lower extremity injury. Results: The result of study revealed that majority (85%) ofpatient were suffering from severe pain and pattern of analgesic were tramadol, paracetamol used by them intravenous route. Conclusion: Pain management in Postoperative period after orthopedic surgery should be given a high priority. While, appropriate pain management strategy should be implemented to decrease postoperative pain.

Online since 31^st August 2020