Muller Journal of Medical Sciences and Research最新文献

{"title":"Functional outcome of limited contact dynamic compression plating and interlocking nailing for fracture shaft of humerus in adults","authors":"V. D’almeida, A. Kamath, Akhil Joseph, Alfred Lobo, T. Pinto","doi":"10.4103/mjmsr.mjmsr_19_23","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_19_23","url":null,"abstract":"Background: Fractures of shaft of humerus are common, accounting 3% of all fractures. They have historically been managed conservatively with hanging casts or a functional brace. However, a lack of fracture reduction with these conservative measures resulted in malunion. Two surgical techniques under study include intramedullary nailing and limited contact dynamic compression plating. This study aims to analyze the functional outcome between the two surgical techniques. Materials and Methods: In this prospective randomized study, 38 patients were treated surgically for shaft of humerus fracture from August 2016 to August 2018 at a tertiary care center. Twenty patients underwent limited contact dynamic compression plate (LCDCP) plating and 18 underwent intramedullary nailing. All were assessed for radiological union, complications, and functional outcome at 6 weeks, 12 weeks, and 1 year using disabilities of arm, shoulder, and hand (DASH) questionnaire. Results: Thirty-eight patients completed the study of which 18 cases (47.5%) with fractures that were treated with interlocking nail and 20 cases that were treated with LCDCP plating. The mean duration to complete radiological healing was 15.06 weeks. The healing rate was relatively faster in the interlocking group as compared to the LCDCP group (P = 0.144). Complications such as shoulder impingement 8 (44.4%), shoulder pain 3 (16.7%), nonunion 1 (5.6%), and shoulder stiffness 1 (5.6%) were found to be more common in interlocking group as compared to LCDCP group, respectively. Whereas, complications such as superficial infection - 1(5%) and radial nerve deficits - 2(10%) were less common in the interlocking group compared to LCDCP group, respectively. The mean follow-up was 11.556 weeks, and the overall DASH score analysis showed better results in LCDCP group. Conclusion: In our study, LCDCP plating showed lower incidence of complications, particularly periarticular complications around the shoulder joint such as shoulder pain, stiffness, and impingement but carried a higher risk of radial nerve injury. Fracture union rates were found to be almost similar between both groups. DASH score analysis showed better functional outcome among the LCDCP plating group. The overall outcome of LCDCP plating over interlocking nailing was found to be better.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45285752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is formative assessment a tool for learning for students during PANDEMICS? – A study among first-phase students of a medical school in North India","authors":"Gesu Singla, Bharti Singla, Shweta Singla, Hitashi Bansal","doi":"10.4103/mjmsr.mjmsr_55_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_55_22","url":null,"abstract":"Introduction: COVID pandemic has shifted the teaching of students from on site to online mode. Initially, it was difficult for the students as well as teachers to acclimatize to this system of education but with the passage of time, this system has imbibed into everyone's life. The feedback given in online formative assessment has proved to be really useful for the students in improving their performance. Materials and Methods: Online oral formative assessment was taken during online classes which were being conducted on the Zoom platform. Later on, students' feedback was taken using a questionnaire created in the form of Google Forms. Results: Students appreciated this method of online oral formative assessment as well as detailed feedback. Furthermore, exposure to multiple questions and answers was altogether beneficial for all. Although there were technical problems like network connectivity which were faced by few students. Conclusions: In lieu of the further waves of the pandemic, if the online mode of education will continue then this method of oral online formative assessment can be a very useful and time-saving method.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44266845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of thyroid function in polycystic ovary syndrome","authors":"S. Dsouza, N. Hegde","doi":"10.4103/mjmsr.mjmsr_63_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_63_22","url":null,"abstract":"Background and Objectives: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder of multifactorial etiology. PCOS is associated with thyroid dysfunctions ranging from subclinical hypothyroidism, autoimmune thyroiditis, hyperthyroidism, and multinodular goiter. This study evaluated thyroid function in patients with PCOS. Methods: This comparative case-control study was done among 186 patients attending the outpatient services of a tertiary care hospital. Patients aged between 18 and 30 years were evaluated; 93 candidates with PCOS were diagnosed using the Rotterdam 2003 criteria and 93 candidates without symptoms or signs of PCOS were selected as controls. Details of symptoms and clinical examination were obtained and their serum thyroid-stimulating hormone and serum-free thyroxine were estimated. Data were statistically analyzed for differences in clinical profile and thyroid function which were compared among the groups. Results: The mean age of the participants was 23.65 and 24.83 years in the case and control groups, respectively. The most common features in the PCOS group were hyperandrogenism (79, 85.9%) and oligomenorrhea (66, 71.7%). The mean body mass index in the PCOS group (23.76 kg/m2) was found to be significantly higher as compared to the controls. Thirty-three (34.4%) patients with PCOS were found to have thyroid dysfunction as compared to 7 (7.5%) in the control group. Among PCOS patients, hypothyroidism was more common than subclinical hypothyroidism. Conclusion: The occurrence of hypothyroidism and subclinical hypothyroidism was found to be higher in patients with PCOS. Hypothyroidism was more frequent among patients in the PCOS group than in the control group.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49500454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant gastric bezoar: A case report and the review of literature","authors":"A. Anees, Shereen Fatima, Yaqoob Hassan","doi":"10.4103/mjmsr.mjmsr_66_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_66_22","url":null,"abstract":"A bezoar is a packed collection of undigested or partially digested food found in the gastrointestinal (GI) tract. The stomach is the most common site of bezoars and bezoars are most commonly found in the stomach and can affect people of any age or gender. Patients with behavioral disorders, abnormal gastric emptying, altered GI motility as in diabetes disorders are predisposed to the formation of gastric bezoars. The majority of gastric bezoars are asymptomatic, whereas others require treatment in the form of endoscopic or surgical removal. Gastric bezoar can occasionally result in serious complications such as gastric outlet obstruction, bleeding, and perforation. As a result, early detection and treatment are critical to avoid potentially serious complications. We report an extremely rare case of giant gastric trichobezoar in a young female that was timely and successfully managed surgically. A 25-year-old female presented with symptoms of repetitive nausea and vomiting, especially postmeals, early satiety, intermittent abdominal pain, weight loss, and abdominal lump. An abdomen examination revealed a mass in the epigastric region extending to the right hypochondrium of 20 cm × 14 cm, firm to hard in consistency with a palpable inferior margin. Ultrasonography and contrast-enhanced tomography scan abdomen confirmed the diagnosis of gastric bezoar. The patient was prepared and Elective OT was done with the removal of a large gastric trichobezoar measuring 24 cm × 16 cm and weighing 1865 g. Gastrostomy closure was done in two layers and the postoperative period was uneventful. The patient is doing well and is on regular follow-up.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43870628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of laboratory parameters and computed tomography findings in real-time reverse transcriptase-polymerase chain reaction-negative individuals","authors":"Malathi Bhat, Soujanya Mynalli, A. Braggs","doi":"10.4103/mjmsr.mjmsr_69_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_69_22","url":null,"abstract":"Context: The diagnosis of COVID-19 relies on the reverse transcriptase-polymerase chain reaction (RT-PCR) obtained from the respiratory tract secretions. Due to various factors, there is a possibility of getting an inaccurate result. The false-negative result would be dangerous as the affected individual would not be subjected to quarantine and would go on to infect others. Hence, there is a need for an alternative in diagnosing COVID-19. Aims: To assess the correlation of computed tomography (CT) findings, laboratory parameters, and outcomes in COVID-19 suspect patients. Design: The study design involves retrospective study. Materials and Methods: RT-PCR-negative COVID suspect individuals were taken. Laboratory parameters such as serum ferritin, serum lactate dehydrogenase (LDH), serum D-dimer, and serum C-reactive protein (CRP) were considered. CT findings in these patients were determined. These parameters were statistically analyzed. Statistical Analysis Used: Frequency, percentage distribution, mean standard deviation, median, interquartile range, and Kruskal–Wallis test. Results: There was a statistically significant correlation between the serum LDH, serum ferritin, and serum CRP with the CT severity findings in RT-PCR-negative COVID suspect individuals. The predominant CT finding was ground-glass opacities. Conclusions: In conclusion, the laboratory parameters and CT findings can be used as an alternative in the diagnosis of COVID-19 in RT-PCR-negative individuals.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43950843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alarm fatigue: Can Indian intensive care unit nurses keep up with the noise and maintain their edge?","authors":"G. Charan","doi":"10.4103/mjmsr.mjmsr_37_23","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_37_23","url":null,"abstract":"Alarm fatigue has become a significant concern for intensive care unit (ICU) nurses. The incessant flood of alarms can result in desensitization, negatively affecting both nurses and consequently, patient care. This article delves into the struggles ICU nurses encounter due to alarm fatigue, its repercussions, and potential strategies to tackle the problem. By comprehending and addressing alarm fatigue, healthcare professionals can foster a safer and more efficient work environment for ICU nurses.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45567645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of dengue endemicity on malaria identification by automated hematology analyzer – Beckman Coulter LH750: A hospital-based cross-sectional study","authors":"Reshma G. Kini, Nidhi Manoj, A. Amin, C. Moras, N. Marla","doi":"10.4103/mjmsr.mjmsr_29_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_29_22","url":null,"abstract":"Aim: Automated hematology analyzers have been used to develop indices and algorithms for diagnosing malaria. We believe that the practical utility of such indices depends on the infection profile in the community since the type of infection determines the hematological parameters and consequently their power to discriminate malaria. Our region is endemic for malaria and dengue. Our aim was to verify the utility of the published malaria factor (MF) in our setting. Materials and Methods: Anticoagulated blood from clinically suspected cases of malaria and dengue were analyzed. The standard deviation and mean (M) values of all the leukocytes were obtained and the MF was calculated. Results: The MF showed a sensitivity and specificity of 75% and 55.1% in identifying malaria at a cutoff of 4.2 when the control group (CG) included dengue-positive (DP) patients and a sensitivity and specificity of 93.4% and 65.2% when the CG did not include DP cases. Using another set of parameters, we developed a Malaria Discriminant Index which showed a sensitivity and specificity of 94.4% and 73.9% in identifying malaria in the absence of dengue at a cutoff of 1.19 and a sensitivity and specificity of 85.5% and 61.7% at a cut off of 1.26 when dengue patients were included in the CG. Conclusion: This study emphasizes the need to verify the utility of indices/factors developed in regions not having similar endemic profiles before utilizing them in the clinical setting as other infections can influence the discriminant capacity.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43099001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunization of children under 5 years: Mother's knowledge, attitude, and practice in a rural community","authors":"Shreya Adavalath, S. Sowmya, KShreedhara Avabratha","doi":"10.4103/mjmsr.mjmsr_46_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_46_22","url":null,"abstract":"Background: Mothers' knowledge, attitude and practice toward childhood vaccination is the most adequate tool for prevention of infectious disease epidemics. A study on the knowledge, attitude and practice regarding immunization will help in our understanding of the variables that influence parental decision-making regarding immunization. Aims and Objectives: To assess the knowledge, attitude and practice regarding immunization in mothers of under 5 children in rural area in Bantwal Taluk in Mangalore. Material and Methods: This was a cross sectional questionnaire-based study conducted on 486 mothers of under 5 children in a rural area in Mangalore from November 2021 – January 2022. Data was collected using pretested semi structured questionnaires. Data was analysed using descriptive statistics, chi square test and outcomes expressed as frequency, proportions and percentages. Results: 99.8% mothers were aware that vaccination prevents children from infectious disease and its complications. 23.2% of the mothers had the misconception that multiple doses of the same vaccine were not important for their child's immunity. Vaccination campaigns to vaccinate their children were not considered important by 4.4% mothers. A significalnt proportion (26.3%) believed that multiple vaccinations at the same time would have a negative impact on their child. Most of the mothers were of the opinion that childhood vaccination was important and vaccination was more beneficial than harmful. 77% were of the opinion that the child could not get infected by the disease once vaccinated. 99.6% of the children were vaccinated at birth and 98.8% of the children were completely immunized. Optional vaccines were not given to majority of the children. Conclusions: Majority of the mothers were aware about the need for vaccination, had positive attitude towards the same and satisfactory immunization practices. Most of the children had completed immunization for their age, which in turn reflects on the adequate knowledge among the mothers.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45012590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of high-fidelity simulation in obstetrics ultrasound training: A fresh perspective in the COVID era","authors":"Mahesh Mijar, Lenon DSouza, Berton Monteiro, Malathi Bhat, Tanushree Kamath","doi":"10.4103/mjmsr.mjmsr_79_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_79_22","url":null,"abstract":"Context: Obstetric sonography is one of the cornerstones in radiology. The exposure of radiology residents in this field is not adequate during their residency life; hence, simulation techniques can be used to bridge the knowledge gap and improve their skills. Aims: The study aimed to evaluate the impact of high-fidelity obstetric sonography simulation in resident training and competency testing. Design: The study design involves interventional longitudinal cohort study. Methods: The study was conducted among 15 radiology residents with the use of Vimedix high-fidelity Ultrasonography simulator. Seven sessions were conducted, following which the evaluation of the training program was done using the Kirkpatrick training evaluation model. The resident's reaction was recorded using the questionnaire, and the change in knowledge was ascertained by the pretest and posttest. A change in behavior was recorded using a questionnaire in the 6-month follow-up. Results: All the domains showed a positive trend after the session three and session seven. The residents were more confident and had an overall improved satisfaction of 97.4% regarding training. The Cronbach's alpha test for this study was 0.812 for session three and 0.867 for session seven. An upward trend was seen in the results of the pretest and posttest scores with P < 0.01. The average pretest mean score was 11.3, and the average posttest mean score was 21.4. A 6-month follow-up showed nearly 95% of the individuals found simulation to be helpful in their daily day-to-day practice. Conclusions: High-fidelity simulators can be used as an adjunct to conventional training in obstetric sonography training of radiology residents.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43925155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study on self-medication in ophthalmic emergencies in the rural population of South India","authors":"SaritaR J Lobo, Kiran Shetty, PG Vinay, LakshmiK Vijayaraghavan","doi":"10.4103/mjmsr.mjmsr_59_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_59_22","url":null,"abstract":"Background: Self-medication has been defined as the taking of drugs, herbs, or home remedies on one's own initiative and advice from another person without consulting a medical specialist. The objective of the study was to identify the pattern of self-medication in ophthalmic emergencies in patients attending the emergency department in a peripheral rural setup in south India. Materials and Methods: This was a descriptive, cross–sectional, questionnaire-based observational study. The patients selected were above 18 years of age. Informed consent was taken. A questionnaire on the demographic characteristics, level of literacy, history of the ophthalmic condition for which the patient had self-medicated, type of self-medication resorted to , reasons for resorting to ocular self–medication, and the adverse effects reported were all noted in the study. Results: The study included 100 subjects. Fifty-three percent were male and 47% were female. Among the 100 subjects, 10% of the individuals were educated above primary school level. Thirty-five percent had only primary school level education and the remaining 55% had not been to a formal school and had no basic education. Among our respondents, the most commonly used self-medication was antibiotic drops (24%), followed by expired medication (23%). 20% used steroid drops. 15% had tried traditional eye medication (TEM). Herbal and other indigenous medications were used by 12% of the responders. 7% used oral nonsteroidal anti-inflammatory drug agents. None of the responders were aware of the adverse effects of self-medication. The most common ophthalmic emergency symptoms faced by our responders were excessive watering (37%), pain (28%), foreign body in the eye (14%), redness and discharge (12%), decreases vision (5%), and pain in the eye (4%). The common reasons given by our responders for not accessing health-care facilities were distance (living far from health-care facilities), advice from family and friends, belief if local healers, lack of finances and poverty, and lack of prioritizing health care. Following self–medication, 30% of the patients had infectious keratitis, 28% had conjunctivitis, 25% had epithelial defects, and 17% glaucoma. Conclusion: Irrational long-term use of drugs/traditional eye medicine or even the usage for ophthalmic emergencies can have dangerous visual outcomes. The study highlights the need of effective execution and establishment of high-quality accessible primary eye care services and health-care referral network in rural India.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43484940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}