Muller Journal of Medical Sciences and Research最新文献

{"title":"A study to compare the performance of students following self-directed learning sessions conducted without online support and self-directed learning sessions conducted with the help of online support in the department of physiology","authors":"P. Sinha, Arun Chaudhuri, D. Adhya","doi":"10.4103/mjmsr.mjmsr_27_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_27_22","url":null,"abstract":"Background: Medical students need to develop self-directed learning (SDL) skills to become life-long learners. Aims: To compare the performance of students following SDL sessions conducted in the offline mode and SDL sessions conducted with the help of online support in the department of physiology. Methodology and Participants: This study was conducted on 200 first-phase MBBS students (Batch 21–22) after taking Institutional Ethical Clearance and informed consent of the participants. Nerve muscle physiology was taught using the two methods of SDL. The assessment was done using multiple choice questions. Pre-test and post-test were conducted for all sessions and ten such sessions were assessed in the present study. Feedback was taken from students and facilitators. Program evaluation was done using Kirkpatrick level 1 evaluation. Pre-test and post-test scores of the same group were compared using the paired t-test and among two groups were compared using an unpaired t-test. Results: Students performed significantly better in SDL sessions where online support was better and the performance of female students was significantly better as compared to male counterparts (87.27 ± 7.09 vs. 84.79 ± 8.49; P<0.001**). Students were satisfied with the SDL sessions and more so with online support. Faculty members and students emphasized that online support increased bonding among students as well as bonding with the facilitators. Conclusions: Providing online support to medical students was found to have positive effects on learning in the present study. Female students developed better problem-solving attitudes and critical thinking abilities as compared to males and were more motivated in learning.","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":"70833275","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":"Femoral hernia: Treatment delay and cause of death – A case report and an integrative review","authors":"Yaqoob Hassan, Abu Shahma, A. Anees, Susheel Kumar","doi":"10.4103/mjmsr.mjmsr_68_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_68_22","url":null,"abstract":"Femoral hernia is an uncommon entity in males and is limited to case reports in the medical literature. Because of the narrow neck of the femoral canal, a femoral hernia can easily incarcerate and/or strangulate. Surgical intervention is the only option for definitive treatment. We report the case of a 59-year-old male patient who presented with a 10 days history of generalised abdominal pain, distension, and a few episodes of vomiting. The patient was resuscitated, and contrast-enhanced CT tomography revealed a left femoral hernia as well as features of small bowel obstruction. A gangrenous ileal loop with perforation within the left femoral canal was discovered after surgery. The patient underwent ileal resection and ileostomy, followed by primary femoral ring repair. However, on postoperative day 3rd, the patient developed a sudden cardiac arrest and died. Proper referral, early diagnosis, and treatment are vital in cases of femoral hernia to avoid such a fatal outcome and could have changed the prognosis of the patient. It is important for peripheral health-care providers to pay attention to persistent abdominal symptoms and to be aware of the proper and timely referral.","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":"46300602","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":"Knowledge of E-Shram card among the rural population of Kurnool district in Andhra Pradesh: A cross-sectional study","authors":"Y. Pranaya, Thilak Anjanappa, Komera Sunanda, Ajay Enibera","doi":"10.4103/mjmsr.mjmsr_6_23","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_6_23","url":null,"abstract":"Background: In India, little thought has been given to how social security programs are used by rural people. Since the people reside in villages, it is possible that they are unaware of these programs and do not fully take advantage of them. E-Shram portal is the first-ever national database of unorganized workers. With registration, workers would get a Universal Account Number card or e-Shram card that allows access to benefits under social security schemes. Hence, the study aimed to assess the knowledge about e-Shram card in Pyalakurthy village. Materials and Methods: A cross-sectional community-based study was carried out among the rural population of Pyalakurthy and 109 members participated in the study. The data were collected using convenient sampling method between April and May 2022. The data were collected using a semi-structured questionnaire through Google Forms, were administered to them by interview method, and were analyzed using Epi-Analysis. Results: A total of 109 participated in the study with a mean age of 42.6 ± 14.7 years, 64 (58.7%) males and 45 (41.3%) females. Nearly three-fourth belonged to Class IV and V socioeconomic status. Only 15% had knowledge about e-Shram card. There was a significant association between knowledge about e-Shram card and education, socioeconomic status, migrants, and smartphone availability. Conclusion: Most of the rural population had poor knowledge about e-Shram card. Creating awareness and doorstep registration services may help them be aware and avail of its benefits.","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":"42204079","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":"Identification of the factors that affect clinical teaching and potential strategies to overcome them: A narrative review","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/mjmsr.mjmsr_70_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_70_22","url":null,"abstract":"Clinical teaching does not limit to teaching alone, rather it actually deals with the process wherein students are supported in their learning process while interacting with real patients during clinical settings. The purpose of the current review was to explore the factors that impact clinical teaching and then propose the potential recommendations to overcome them. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines and 39 articles were selected based on their suitability with the current review objectives and analyzed. Keywords used in the search include clinical teaching, patient, student, and teacher in the title alone only. Clinical teaching is affected by a wide range of teacher-related, student-related, and patient-related factors, and as medical educators, we are aware of these factors so that we can minimize their impact to enhance the effectiveness of clinical teaching, thereby augmenting learning among medical students. Most of the identified factors that can influence clinical teaching can be taken care of in one or another way, if we strengthen the domain of the faculty development program. The shortage of patients, this concern can be managed by either adoption of standardized patients or by ensuring clinical teaching in outpatient department settings. To conclude, clinical teaching is an important aspect of the making of a competent medical graduate. However, the effectiveness of such sessions depends immensely on the stakeholders that are involved in the process. It is the need of the hour to identify the prevailing factors and then plan for corrective measures to neutralize the impact of such factors and also simultaneously enhance learning among students.","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":"44163125","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":"My five moments of hand hygiene: A cross sectional questionnaire based study on adherence and barriers among nurses in central Kerala","authors":"S. Sebastian, S. Madhumitha, LiyaMariam George, KS Meenakshi, AlphonsaClara Vinson, A. Benjamin","doi":"10.4103/mjmsr.mjmsr_30_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_30_22","url":null,"abstract":"Background: Hospital acquired infections have remained a concern in the field of health care as a major cause of increasing morbidity, mortality and health care costs in healthcare facilities. In the present era of emerging and re-emerging infectious diseases and multidrug resistant pathogens, there is a growing emphasis on basic measures of prevention of infections, like maintaining good hand hygiene. Although The World Health Organization (WHO) has issued guidelines on hand washing procedure with an aim to reduce the prevalence of hospital associated infections, the compliance amongst health care workers is poor. Objective: To study the adherence and barriers relating to non-adherence to the five moments of hand hygiene among nursing staff in Central Kerala. Materials and Methods: The present cross sectional study was conducted among 360 female nurses using Snowball sampling technique. The quantitative data collected was analysed using the software SPSS version 20. Chi-square test was used for comparison of proportions across groups. Logistic regression analyses were used to find out the determinants of non-adherence. The qualitative data collected was analysed using thematic analysis and classified into themes and subthemes. Results: Out of 338 study participants, 304 (90%) reported to be adherent to the 5 moments of Hand Hygiene. The present study found that factors associated with hand hygiene behaviour among study participants were awareness about Hand Hygiene and educational qualification. Conclusion: The existing level of non-adherence can be a source for outbreak of hospital acquired infections in the community and hence needs to be addressed.","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":"46965169","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":"Chronic obstructive pulmonary disease – A neglected and underestimated chronic lung disease in India: A large single-center study in India","authors":"S. Patil, Deepak Patil, G. Gondhali","doi":"10.4103/mjmsr.mjmsr_48_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_48_22","url":null,"abstract":"","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":"70833764","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":"Toxic granules in neutrophils in sepsis patients: Does it really helpful?","authors":"Subhash Chander, Reetika Sharma, Anuradha Sharma, Priyanka Verma","doi":"10.4103/mjmsr.mjmsr_26_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_26_22","url":null,"abstract":"Introduction: Timely diagnosis of bacteremia/sepsis is essential for the initiation of antimicrobial therapy and further reducing morbidity and mortality. Aims and Objective: This study is undertaken to find out the importance of toxic granulations in neutrophils in the diagnosis of sepsis. Materials and Methods: This was a cross-sectional type of study which was carried out for 1 year (August 2020 to August 2021). A total of 100 cases were included in the study. The smears were studied to assess the differential leukocyte count and neutrophils toxic granules. Observations and Results: The age of the patients ranged from 11 to 92 years, with M:F ratio 1:1. Total leukocyte count (TLC) ranged from 1.6 to 37.3 × 109/l with a mean of 14.7 × 109/l. Absolute neutrophil count (ANC) varied from 1.31 × 109/l × to 32.4 × 109/l with a mean of 10.4 × 109/l. On peripheral smear examination, 31% of cases showed no granules in the neutrophils, 35% of cases showed scattered darkly stained granules in the cytoplasm of neutrophils (1+), 29% showed an increase in the number of granules and increase in intensity (2+), and only 5% cases showed numerous granules with increase blue–black stain. However, none of the cases showed numerous coarse granules crowing the cytoplasm (4+). Conclusion: In this study, we found that none of the single parameters, for example, the TLC and ANC, toxic granulations, and left shift are diagnostic of sepsis but all these are complementary to each other in predicting the diagnosis of sepsis.","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":"43943726","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":"Human papilloma virus-related oral and oropharyngeal squamous cell carcinoma: An assessment of histomorphological features","authors":"Anasuya Lenka, U. Ghosh, D. Mohapatra, R. Tripathy","doi":"10.4103/mjmsr.mjmsr_64_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_64_22","url":null,"abstract":"Background: Human papillomavirus (HPV) has emerged as an important cause of oral and oropharyngeal squamous cell carcinomas (OSCC and OPSCC). Cancers with HPV as a causative agent are seen to exhibit certain specific histomorphological features. Aim: This study aims to describe the histomorphology of oral and oropharyngeal cancers and discuss their association with HPV. Material and Methods: Hospital-based prospective study done over 31 months (December 2018–April 2021), including a total of 90 cases of OSCC and OPSCC. They were subjected to detailed histopathological evaluation, DNA polymerase chain reaction testing for testing of HPV association, followed by the analysis of data by statistical methods. Results: Out of a total of 90, 73 cases were OSCC and 17, OPSCC. A total of 15 cases were HPV positive. HPV status was found to be significantly associated with purely nonkeratinizing tumors and hybrid/mixed squamous cell carcinomas, pushing the pattern of invasion, absence of perineural invasion, presence of tumor infiltrating lymphocytes, moderate-to-dense host lymphocyte response, loose stromal response, absence of tumor budding, and high mitotic rate (>20/10 hpf). Conclusion: HPV-positive OSCC and OPSCC have distinct histomorphological features and careful analysis of the same can assist in identifying these types of cancers better and thus help in prognostication and treatment.","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":"42309265","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":"Clinical profile of term neonates requiring intervention for hyperbilirubinemia","authors":"A. Lobo, S. Shanbhag, Saritha Paul","doi":"10.4103/mjmsr.mjmsr_83_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_83_22","url":null,"abstract":"Introduction: Neonatal jaundice is the imbalance between bilirubin production and conjugation, resulting in increased serum bilirubin levels. It is visible in the skin and eyes, only when the total serum bilirubin level exceeds 5–7 mg/dl. Sixty percent of the term and almost 80% of the preterm babies develop neonatal jaundice. Objectives: To identify the etiology of neonatal hyperbilirubinemia in term neonates and to determine short-term outcomes in terms of rebound hyperbilirubinemia during hospital stay and other modalities of intervention in these babies. Methods: We did a cross-sectional, descriptive, and retrospective chart-based study. The clinical profile of term neonates treated for hyperbilirubinemia was procured from the inpatient medical records and neonatal intensive care unit (NICU) discharge summaries over 5 years from January 2017 to December 2021. Short-term outcomes, such as duration of hospital stay, rebound hyperbilirubinemia, and other modalities of treatment used, were noted. Results: A total of 252 term babies who fulfilled the inclusion criteria were included in the study. Two hundred and thirty-four babies were delivered vaginally, 10 by cesarean section, and 8 extracted by instrumental delivery. Ninety-eight babies had ABO incompatibility and 19 Rh incompatibility. Twelve babies had elevated cord thyroid-stimulating hormone levels. Seventy-one babies had signs of bilirubin encephalopathy. Thirty-nine babies had sepsis. Fifty-three of them had significant weight loss suggestive of improper feeding. Thirty-three babies had cephalhematoma. Nine babies were born to mothers with gestational diabetes mellitus. All 252 babies underwent phototherapy. Thirty-two babies required a prolonged hospital stay of more than 1 week and seven had rebound hyperbilirubinemia. Nine babies required exchange transfusion. Two received intravenous immunoglobulin. Conclusions: The most common risk factor associated was ABO incompatibility, followed by inadequate breastfeeding. As only nine neonates required exchange transfusion, early and prompt initiation of phototherapy remains the best modality of treatment. Emphasis on proper feeding technique can go a long way in preventing admission to NICU, as it is the second-most common preventable cause of hyperbilirubinemia.","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":"41491650","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":"Coronavirus disease-2019 incidence and local wind speed: Is there any association?","authors":"B. Joob, V. Wiwanitkit","doi":"10.4103/mjmsr.mjmsr_28_23","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_28_23","url":null,"abstract":"","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":"46126841","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}