Muller Journal of Medical Sciences and Research最新文献_第9页

Interobserver variation of psoriasis area and severity index in a clinical setting 临床环境中银屑病面积和严重程度指数的观察者间差异

Muller Journal of Medical Sciences and Research Pub Date : 2020-07-01 DOI: 10.4103/mjmsr.mjmsr_1_20

N. Dias, B. Kishore, D. Sukumar

{"title":"Interobserver variation of psoriasis area and severity index in a clinical setting","authors":"N. Dias, B. Kishore, D. Sukumar","doi":"10.4103/mjmsr.mjmsr_1_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_1_20","url":null,"abstract":"Background: Severity scoring systems are important parameters in assessing the severity of a disease aiding in categorization of disease and its prompt treatment. However, reliability of these scoring systems and inter-observer variation is a concern. In the recent years, there has been a lot of debate on reliability of Psoriasis Area and Severity Index (PASI) scoring as there is a wide range of difference in the scoring when assessed by each observer. We conducted this study to assess the inter-observer variation of PASI scoring observed in out-patient department of Dermatology at a tertiary care hospital. Methods: Total of 35 patients clinically presenting with chronic plaque type psoriasis, irrespective of disease duration and treatment taken were enrolled in the study. PASI scoring was assessed by 3 different observers (2st year, 3nd year postgraduate residents and clinical staff) independently on each patient and reliability was determined by intra-class coefficient. (ICC). Results: Our study showed an excellent reproducibility of PASI score when an inter-observer variation was performed. Most of the parameters showed an agreement of >0.9 (ICC) which was statistically significant (<0.001). However it was noted that “erythema” in head, upper limbs and lower limbs was in less agreement with ICC when compared to other parameters, yet excellent. Mean PASI score was 10.96, 10.78 and 10.47 among observer 1, 2 and 3 respectively. Conclusion: Our study concludes that PASI is a reproducible and reliable clinical tool with less inter-observer variation if done by trained qualified observers to assess the severity of chronic plaque type psoriasis although its application gets tedious and difficult in busy dermatology clinics. Limitation: A small sample size.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45970445","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}

引用次数: 0

Measure what you treasure! – A maternity dashboard 衡量你所珍视的孕妇仪表板

Muller Journal of Medical Sciences and Research Pub Date : 2020-07-01 DOI: 10.4103/mjmsr.mjmsr_32_20

J. Jyothsna, Prema D' Cunha, Chethana Bolanthakodi

{"title":"Measure what you treasure! – A maternity dashboard","authors":"J. Jyothsna, Prema D' Cunha, Chethana Bolanthakodi","doi":"10.4103/mjmsr.mjmsr_32_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_32_20","url":null,"abstract":"Background: Clinical quality dashboards equip hospitals with a simple method for maintaining and monitoring clinical quality indicators. The maternity dashboard. provides an opportunity to integrate managerial, organizational, and clinical audits to improve quality of care. It has four broad categories: clinical activity, workforce, clinical outcome, and complaints/risk incidents. It can be used to benchmark activity and monitor performance against the standards agreed locally for the maternity unit on a monthly basis. Aim: The aim of this study was to design and implement a maternity dashboard to improve maternal and child health care. Settings and Design: This was a retrospective observational study conducted at a tertiary care hospital. Materials and Methods: Data were collected manually from outpatient department, labor ward, neonatal intensive care unit registers, and electronic records from June 2018 to May 2019 in a tertiary care hospital. Goals for each of the parameters were set, as well as upper and lower thresholds, and the data were analyzed. A suggested approach is to use the traffic light system, such as “green,” “amber,” and “red.” All the parameters after analyzing were noted on the dashboard. Results: During the study period of 1 year, there were 3750 deliveries. Auditing was done for various clinical activity indicators along with clinical outcome (both maternal and neonatal) and triaged using traffic light colors on a monthly basis. Conclusions: Maternity dashboard facilitates targeted quality improvement initiatives. They help in comparing current performance against expected standards and hence helpful in driving changes toward optimum maternal and child health.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42288779","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}

引用次数: 0

The role of magnetic resonance imaging in the diagnosis of bilateral laryngocele 磁共振成像在双侧喉膨出诊断中的作用

Muller Journal of Medical Sciences and Research Pub Date : 2020-07-01 DOI: 10.4103/mjmsr.mjmsr_39_20

E. Robinson, C. Wekhe

{"title":"The role of magnetic resonance imaging in the diagnosis of bilateral laryngocele","authors":"E. Robinson, C. Wekhe","doi":"10.4103/mjmsr.mjmsr_39_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_39_20","url":null,"abstract":"Laryngocele is a rare anomalous air-filled dilatation of the saccule of the larynx with unclear etiology. The patient in our case presented with a complaint of a painless anterior neck swelling which moved and increased in size on coughing, swallowing, and straining. Physical examination revealed a compressible swelling measuring approximately 2 cm in the widest diameter in the anterior aspect of the neck with normal overlying skin. It was nontender, soft, cystic, fluctuant, and mobile. The advent of magnetic resonance imaging (MRI) has made its diagnosis easier than the use of laryngoscope. The finding revealed multiple, nonenhancing, oval-shaped but lobulated masses in both infrahyoid visceral spaces involving the paraglottic space with an extralaryngeal component. They hypo to isointense on T1-weighted and hyperintense on T2-weighted and short tau inversion recovery images and measured 3.71 cm × 3.06 cm in the right and 1.27 cm × 1.04 cm in the left (right bigger than left). Hence, a diagnosis of bilateral laryngocele was made. In the index report, MRI being a noninvasive imaging modality using radiofrequency with brilliant soft-tissue contrast and spatial resolution was used to diagnose the lesion. The paucity of literature and information with regard to bilateral laryngocele in our environment and the role of MRI have informed this report.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46016851","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}

引用次数: 0

Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature 原发性肛门直肠黑色素瘤:多模式管理在一系列的四个病例和文献回顾

Muller Journal of Medical Sciences and Research Pub Date : 2020-07-01 DOI: 10.4103/mjmsr.mjmsr_37_20

Nishant Lohia, Manoj Prashar, S. Harish, Sankalp Singh, Anand Subramananiam, S. Viswanath, R. Ranjan, G. Trivedi

{"title":"Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature","authors":"Nishant Lohia, Manoj Prashar, S. Harish, Sankalp Singh, Anand Subramananiam, S. Viswanath, R. Ranjan, G. Trivedi","doi":"10.4103/mjmsr.mjmsr_37_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_37_20","url":null,"abstract":"Anorectal melanoma is a very rare and aggressive mucosal melanocytic malignancy, accounting for 1% of all anorectal cancers. There have only been a few cases reported. Surgical resection remains the mainstay of treatment. No definitive management strategies exist because of the absence of randomized trials. We here report a case series on four cases of anorectal melanoma. All four cases underwent abdominoperineal resection (APR) and nodal dissection. Two out of four cases received adjuvant temozolomide (TMZ), one case received adjuvant doublet chemotherapy with TMZ and cisplatin, and the fourth case succumbed to nononcological disease before he could be subjected to adjuvant chemotherapy. In the first and third case, nodal dissection was limited to pelvic nodes only. However, in the second case, extensive nodal dissection in the form of bilateral pelvic and inguinal lymph nodal dissection and para-aortic lymph nodal dissection was performed. The fourth case also was subjected to extensive nodal dissection in form of bilateral pelvic and para-aortic lymph node dissection. The first patient however became metastatic at the end of first cycle of adjuvant TMZ and succumbed to his illness post 3 months of surgery. The second patient could complete all six cycles of adjuvant TMZ, and after 1 year of completion of adjuvant TMZ, he presented with skeletal and brain metastases. He also received palliative whole-brain radiotherapy for brain metastases. He finally succumbed to his disease 18 months after surgery. The third case completed all six cycles of adjuvant TMZ and is still alive with disease-free interval of around 1 year. The fourth case succumbed to nononcological death around 1 month after surgery.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43853459","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}

引用次数: 0

A study on knowledge, attitude, and practice of medical, paramedical, and dental students of a tertiary care institution toward consumption of fast foods 一项关于高等保健机构医学、辅助医学和牙科学生对快餐消费的知识、态度和实践的研究

Muller Journal of Medical Sciences and Research Pub Date : 2020-07-01 DOI: 10.4103/mjmsr.mjmsr_10_20

D. Patnana, Bhavana Chopparapu, Swathi Dulla, L. Kutikuppala

{"title":"A study on knowledge, attitude, and practice of medical, paramedical, and dental students of a tertiary care institution toward consumption of fast foods","authors":"D. Patnana, Bhavana Chopparapu, Swathi Dulla, L. Kutikuppala","doi":"10.4103/mjmsr.mjmsr_10_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_10_20","url":null,"abstract":"Background: Fast food generally refers to food that people intend to consume quickly either on- or off-site. Junk foods are foods that contain little or no proteins, vitamins, or minerals but are rich in salt, sugar, and fats and are high in energy (calories). Excess consumption of fast food has been linked with a variety of health problems including obesity and type II diabetes. Fast foods tend to contain high trans-fat levels which tend to raise amounts of low-density lipoprotein in the human body leading to ill effects on health. Aim: The aim of this study was to know the knowledge, attitude, and practice of medical, paramedical, and dental students toward consumption of fast foods. Materials and Methods: This study is carried out at Konaseema Institute of Medical Sciences and Research Foundation for 2 months among 658 students from medical, dental, and paramedical courses. Students were asked to fill a self-administered questionnaire, and acquisition of data from those filled questionnaires was done. Data entry and assessment were done in MS Excel and depicted as required. Results: Six hundred and fifty-eight students of medical, dental, Bachelor of Physiotherapy (BPT), and nursing courses participated in this study, out of which 421 (64%) are MBBS, 165 (25%) are BDS, 39 (6%) are BPT, and 33 (5%) are nursing students. Conclusion: Hygienic practices should be maintained at fast-food outlets and restaurants. A law postulating to label nutritional information for unpacked foods before serving should be implemented.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48830783","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}

引用次数: 0

Ovarian hyperstimulation syndrome following natural conception 自然受孕后的卵巢过度刺激综合征

Muller Journal of Medical Sciences and Research Pub Date : 2020-07-01 DOI: 10.4103/mjmsr.mjmsr_2_20

S. Garg, Arpita Jain, U. Sharma, Vatsal Thakral

引用次数: 0

An unusual occurrence of synchronous gastrointestinal stromal tumor and high-grade serous carcinoma of the endometrium - A rare combination 罕见的同步性胃肠道间质瘤和子宫内膜高级别浆液性癌的合并

Muller Journal of Medical Sciences and Research Pub Date : 2020-07-01 DOI: 10.4103/mjmsr.mjmsr_35_20

D. Fonseca, S. Arya, K. Raju

引用次数: 1

Improving physical activity among adolescents through multisectoral actions: World Health Organization 通过多部门行动改善青少年的体育活动：世界卫生组织

Muller Journal of Medical Sciences and Research Pub Date : 2020-01-01 DOI: 10.4103/mjmsr.mjmsr_25_20

S. Shrivastava, P. Shrivastava

引用次数: 0

Corona virus disease-2019 pandemic: Ensuring delivery of essential HIV services 2019冠状病毒病：确保提供基本的艾滋病毒服务

Muller Journal of Medical Sciences and Research Pub Date : 2020-01-01 DOI: 10.4103/mjmsr.mjmsr_31_20

S. Shrivastava, P. Shrivastava

引用次数: 0

Vulvovaginal fibroepithelial stromal polyp with myxoid stroma: A diagnostic dilemma on histology – Report of two cases 外阴阴道纤维上皮间质息肉伴黏液样间质:组织学上的诊断困境——附两例报告

Muller Journal of Medical Sciences and Research Pub Date : 2020-01-01 DOI: 10.4103/mjmsr.mjmsr_27_20

U. Ghosh, D. Mohapatra, N. Sahoo

引用次数: 1