RESUMEN
Penetrating trauma to the back causes the anesthesiologist many difficulties in airway management and obtaining central lines due to the inability to position supine. Lateral position intubation for the same has been described earlier but still remains unfamiliar. Here, we describe the case of a stab injury to the back and how we achieved the optimal supine position using the "Two Trolley Technique."
RESUMEN
OBJECTIVE: To assess the sanitary condition and water quality of household wells and to depict it spatially using Geographic Information System (GIS) in an urban area of Trivandrum, Kerala state, India. STUDY DESIGN: A community-based cross-sectional census-type study. METHODS: Study was conducted in an urban area of Trivandrum. All households (n = 449) residing in a 1.05 km2 area were enrolled in the study. Structured questionnaire and Differential Global Positioning System (DGPS) device were used for data collection. Water samples taken were analyzed in an accredited laboratory. RESULTS: Most of the wells were in an intermediate-high contamination risk state, with more than 77% of wells having a septic tank within 7.5 m radius. Coliform contamination was prevalent in 73% of wells, and the groundwater was predominantly acidic with a mean of 5.4, rendering it unfit for drinking. The well chlorination and cleaning practices were inadequate, which were significantly associated with coliform contamination apart from a closely located septic tank. However, water purification practices like boiling were practiced widely in the area. CONCLUSION: Despite the presence of wells with high risk of contamination and inadequate chlorination practices, the apparent rarity of Water-borne diseases in the area may be attributed to the widespread boiling and water purification practices at the consumption level by the households. GIS technology proves useful in picking environmental determinants like polluting sources near the well and to plan control activities.