Abstract Background: Road traffic injuries (RTIs) are still a major cause of preventable mortality, especially in growing urbanised areas of low- and middle-income countries. There is little information on the application of spatial clustering and micro-level (thana-level) analysis in association with autopsy results on zones of high risk and factors contributing to fatal outcomes. Aim: The aim of the study was to analyse the multi-level spatiodemographic clustering and identify the predictive determinants of fatal RTIs using autopsy. Materials and Methods: A retrospective observational study was conducted on 10,617 medico-legal autopsy cases at King George’s Medical University, Lucknow. Data were analysed for age, gender, zone and thana-wise distribution. Statistical analysis included descriptive statistics, Chi-square test and logistic regression to identify significant associations and predictors. Results: A strong male predominance (84.2%) was observed, with the majority of cases occurring in the 18–45 years age group (~60%). Spatial analysis revealed significant clustering in the West Zone (66.9%), identified as the primary high-risk area. Thana-wise distribution showed an apparent dominance of Chowk (57.06%), which was attributed to medico-legal referral bias due to its jurisdiction over the tertiary care centre. Other thanas such as Gomti Nagar and Wazirganj represented actual high-risk zones. Chi-square analysis showed a significant association of age with zone ( P < 0.01), while regression identified West Zone (odds ratio = 3.82) as the strongest predictor. Conclusion: RTA fatalities demonstrate a structured spatiodemographic pattern driven primarily by environmental exposure, with demographic factors acting as modifiers. Recognition of referral bias and micro-spatial clustering is essential for accurate interpretation and targeted intervention.
Abstract Introduction: Maternal and child health remains a priority in India and Primary Health Centres (PHCs) are the first point of care for antenatal and child health services. However, outpatient service quality remains variable, underscoring the need for systematic quality assessment to identify gaps and guide improvement. Objective: The objective of this study is to assess the quality of maternal and child health services delivered in PHC outpatient departments in Bhavnagar district using the National Quality Assurance Standards (NQAS) tool and to identify key gaps. Methods: A cross-sectional study was conducted in all 46 functional PHCs of Bhavnagar district, Gujarat, from September 2023 to November 2025. Outpatient services were assessed using the NQAS checklist across eight domains through observation, interviews and record review. Each checkpoint was scored from 0 to 2. Data were analysed using Epi Info 7.0 and presented as proportions and percentage scores. Scores of ≥70%, 36%–69% and ≤35% were classified as good, fair and poor, respectively. Results: Of 46 PHCs, 12 (26.08%) were rated good, 29 (63.04%) fair and 5 (10.86%) poor. Service provision and clinical care scored the highest, whereas quality management and outcomes were the weakest. Functional antenatal clinics were available in 76.09% PHCs and essential medicines in 93.48%. Updated Standard Operating Procedures (SOPs) were available in only 4.35%, with inadequate antenatal consultation time in 82.61%. Conclusions: Half of the PHCs achieved good quality scores, but important gaps persisted in quality management, SOPs, and antenatal consultation time.
Abstract Background: Infusion therapy forms an integral part of emergency/acute care medicine, and there continue to be many challenges, such as infusion errors, catheter-related complications, infections, medication errors, and occupational health concerns, in the delivery of safe intravenous therapy. Hence, this Society for Acute Care Trauma and Emergency Medicine guideline sought to provide evidence-based recommendations for safe infusion practices in acute emergency situations. Methodology: A systematic Delphi consensus process was undertaken. The operational definitions for safe infusion practice were defined by the steering committee. Evidence was obtained from searches conducted within PubMed/MEDLINE, EMBASE, Cochrane Database, World Health Organization, Centers for Disease Control and Prevention, Infusion Nurses Society, Institute for Safe Medication Practices, Joint Commission and other sources. The strength of recommendation was scored using a five-point Likert scale. Results: One hundred and one recommendations were made within 11 categories, which include training and technology, hand hygiene, difficult venous access, peripheral venous catheter insertion and management, infusion processes, infusion technology, prevention of drug administration errors, waste management, training methods and telemedicine/arteficial intelligence. Sixty-three recommendations had reached a high degree of consensus, 24 reached a medium degree of consensus and 14 were considered weak. A total of 55 recommendations reached consensus in the first iteration of the Delphi process, and 46 needed modification/re-evaluation. The scores of agreement were between 72.4% and 97.2%. Conclusions: The recommendations developed by the current study can serve as a systematic and practical approach to ensure infusion safety in the setting of emergency and acute care.
Abstract Introduction: Tuberculosis (TB) and diabetes mellitus (DM) pose dual public health challenge, especially in low- and middle-income countries like India. DM increases susceptibility to active TB and complicates its treatment, while TB can impair glycaemic control. This study assessed the relationship between various forms of TB and factors affecting the clinical outcomes and morbidity associated with TB. Methods: A cross-sectional study was conducted from 2023 to 2024 at LLRM. Medical College, Meerut, involving 162 patients of pulmonary TB (PTB), extra-PTB (EPTB) and disseminated TB. Patients underwent clinical, biochemical, radiological evaluation and sleep assessment using the Pittsburgh Sleep Quality Index (PSQI). Results: The prevalence of DM was 21.6% in TB patients. No significant association was found between DM and type of TB infection (PTB, EPTB and disseminated TB) ( P = 0.183). PTB patients were older than EPTB and disseminated TB patients. Disseminated TB patients had the lowest body mass index and highest underweight prevalence. Dyslipidaemia – particularly high low-density lipoprotein and low high-density lipoprotein – was common in pulmonary and disseminated TB. Sleep quality improved significantly after 1 month of antitubercular therapy (ATT) (mean PSQI from 8.64 to 5.55; P < 0.001), with no significant early change in fasting glucose after 2 h of ATT. Conclusion: DM is common among TB patients, highlighting the need for routine screening and integrated metabolic management to improve outcomes. Sleep quality improved significantly after 1 month of ATT. However, there was no significant change in fasting glucose after 2 h of ATT.
Abstract Background: Medical devices are commonly utilised in healthcare and can sometimes lead to medical device-associated adverse events (MDAEs) and compromise patient safety. The Materiovigilance Programme of India was instituted to monitor and record such instances; however, knowledge and reporting among healthcare personnel remains inadequate. Therefore, this study was conducted to analyse the knowledge, attitudes and practices (KAP) of materiovigilance among resident doctors and to determine the factors impacting the reporting of MDAE. Methods: A cross-sectional questionnaire-based study was undertaken among 210 resident doctors (1 st year to 3 rd year) working in a tertiary care teaching hospital in Navi Mumbai. Data were gathered using a pre-validated 15-item questionnaire to measure KAPs and factors affecting MDAE reporting. Descriptive and inferential statistics were performed using SPSS version 20. Results: Knowledge regarding Materiovigilance was poor in 32.86%, moderate in 49.52% and good in 17.62% of the participants. Overall, most of the residents had positive attitudes and views toward MDAE reporting, as 89.5% reported that it was important for patient safety. However, only 17.14% had ever witnessed an MDAE and just 11.1% had reported it. The main impediments found were lack of awareness of reporting procedures, ambiguity about reporting requirements and time constraints. Facilitators were easy access to reporting forms, simpler reporting systems and training programmes. Conclusion: Resident doctors demonstrated a positive attitude toward materiovigilance but had gaps in knowledge and reporting practices. Regular training, increased awareness and simpler reporting systems could improve MDAE reporting and patient safety.
