BACKGROUND: Medical, dental, nursing and midwifery students are at high risk for occupational exposure to blood-borne pathogens (BBPs) via sharp injuries such as needle stick injuries (NSIs). AIMS: The aim of this study was to determine the frequency of NSIs and the knowledge, attitude and practices of these students regarding their prevention. SETTINGS AND DESIGN: The clinical students at Shiraz University of Medical Sciences, Iran, were eligible to participate in a survey conducted by a self-administered questionnaire in 2004, asking them about NSIs during their clinical training undergraduate years. MATERIALS AND METHODS: A cross-sectional study evaluated NSIs and practices regarding protective strategies against BBPs in medical, dental, nursing and midwifery students at Shiraz University, Iran, in 2004. These students completed a self-administered questionnaire. STATISTICAL ANALYSIS: The data were entered into a personal computer using Epi-Info (version 2000). Chi-square and Fisher's exact tests for categorical variables and student t-test for continuous variables were performed, where appropriate, using SPSS version10. Alpha was set at the 5% level. RESULTS: The questionnaire was completed by 688 (53%) students. 71.1% (489/688) of the students had NSIs that most commonly (43.6%) occurred in patient rooms. 82% (401/489) of NSIs were not reported. 87.8% (604/688) of the students received information about standard isolation precautions and 86.2% of them had been vaccinated against hepatitis B. CONCLUSION: NSIs and non-reporting of NSIs were highly prevalent in these students. Education about the transmission of blood-borne infections, standard precautions and increasing availability of protection strategies must be provided.

AIM: To assess risk factors, mortality and "near-miss" morbidity in early PPH. SETTING AND DESIGN: Retrospective analysis of 178 women with early PPH (within 24 h of delivery) over 4 consecutive years in a tertiary care hospital in North India. MATERIALS AND METHODS: All case sheets of patients identified by labor record registers as having early PPH were reviewed by the same person to identify the actual impact of condition. The data was analyzed by chi-square analysis. RESULT: Early PPH (loss of blood that caused significant alteration in maternal condition or blood loss 500 in vaginal deliveries or >1000 cc in cesarean section) was recorded in 178; 90 delivered in hospital (Group-A) and 88 referred after delivery (Group-B) from various peripheral centers, i.e., maternity hospitals, nursing homes, district and community health centers. The maternal mortality ratio during this period was 1049/100,000 (139 deaths/13248 live births; direct maternal deaths = 94). Early PPH accounted for 11/94 direct maternal deaths (11.7%). Of these 11 deaths, 3 were in group A and 8 in group B. "Near-miss" morbidity was higher than mortality (Total 19/178; 5/90 in Group-A and 14/88 in Group-B). Delayed referral and lack of active 3rd stage management in Group-B were responsible for most of the adverse events. CONCLUSION: Both "near-miss" morbidity and mortality in early PPH reflect the level of obstetric care in the developing world. These need to be reduced by strengthening peripheral delivery facilities, active 3rd stage management and early referral.

Cerebrovascular manifestations are uncommon presentations of scorpion sting in the Indian subcontinent. A prospective study was carried out on 50 patients with scorpion sting referred to the Government General Hospital during the period from April 2004 to March 2005. In all the patients, detailed history, physical examination with a specific neurological examination and routine biochemical testing and fundus examination were done. Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) were done in cases with neurological deficit. All these patients also underwent a complete hematological, rheumatologic and cardiovascular work-up for stroke. Cerebrovascular involvement was noted in four patients (8%). Hemorrhagic stroke was noted in two patients (4%) and thrombotic stroke was noted in two patients (4%). The mean time of presentation of neurological symptoms was 2 days. Stroke has been a common presentation in our series (8%). Contrary to world literature, there have been no reports of cranial nerve palsies or neuromuscular involvement in our series.