Journal of Medical Academics最新文献

{"title":"Battle of COVID-19","authors":"G. Kaur","doi":"10.5005/jp-journals-10070-0071","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0071","url":null,"abstract":"It was in January 2021 the free vaccination against COVID-19 commenced in India and the government urged all of its citizens to get vaccinated which was expected to be the largest vaccination program in the world. Out of the various COVID-19 vaccines that were under various stages of clinical trials in India, four were developed in the country. Covishield (the name employed in India for the Oxford-AstraZeneca vaccine) and Covaxin, the home-manufactured vaccine produced by Bharat Biotech had received approval from the Drug Controller of India. Indian manufacturers had stated that they can meet the country’s future needs for COVID-19 vaccines. The manpower and cold-chain infrastructure established before the pandemic was sufficient for the initial vaccination of 30 million healthcare workers and was strengthened further to cater to the entire population subsequently. The Indian government had taken urgent measures to expand the country’s vaccine manufacturing capacity and has also developed an efficient digital system to address and monitor all the aspects of vaccine administration. It brings in the sequential events in the battle against COVID-19 in India.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132536364","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":"Use of a Safe Nasal/Oral Sampling Aid in the COVID-19 Pandemic Era","authors":"R. Goel, Rolli Khurana, S. Dubey, V. Pal","doi":"10.5005/jp-journals-10070-0069","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0069","url":null,"abstract":"bstrAct Background: Coronavirus disease-2019 (COVID-19) was first detected in Wuhan, China, after which it quickly spread throughout the world despite several precautions. It has been noted that the healthcare workforce is most susceptible to it. Maximum exposure to them was observed at the time of collection of the mucous sample. Similar activities such as nasal/oral endoscopy or biopsies also put the healthcare workers in harm’s way. Aims and objectives: A simple device was developed which would allow nasal or oral mucous sampling to be done without the patient having to take off the face mask. This would then be tested in field settings to ensure acceptability, efficacy, and safety to healthcare workers. Materials and methods: A prototype device consisting of four parts was designed. The device can clip onto the surgical mask using the disks. Once the trocar has punctured the mask, the valve can be opened to allow a swab-stick or endoscope of up to 5 mm to be passed through it. This valve creates a tight seal when released and decreases aerosol spread in the instance that the patient coughs or sneezes. Results: One hundred and fifty patients who reported for COVID testing at our hospital and 89 patients who reported for nasal or oral endoscopy were sampled or examined using this device. Minor difficulties of the loose fit of the device on the mask, tight valve, and inability to find nasal opening were noted. Discussion: Our team was able to successfully develop an affordable and effective device—nasal/oral sampling aid (NOSA). Our preliminary trials found it to be dramatically effective for patient and doctor safety. It reduced instances of aerosol dispersion and gave security to the entire sampling process.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120979994","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":"Thoracic Paravertebral Block as an Alternative to General Anesthesia in Patients with Hypertrophic Cardiomyopathy for Elective Breast Surgeries: A Case Series Study","authors":"Rakesh Sharma, Shalendra Singh, Priya Taank, G. Ambooken, V. Krishna","doi":"10.5005/jp-journals-10070-0066","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0066","url":null,"abstract":"A bstrAct Hypertrophic cardiomyopathy (HOCM) is a cardiac disease characterized by asymmetric hypertrophy of the interventricular septum (IVS), causing intermittent obstruction of the left ventricular outflow tract (LVOT). Sympathetic stimulation during general anesthesia (GA) in HOCM patients poses the risk of sudden intraoperative death. It is pertinent to appreciate that surgery and anesthesia often complicate the perioperative outcome if adequate monitoring and proper care are not taken. Therefore, a complete understanding of the pathophysiology, hemodynamic changes, and anesthetic implications of HOCM is required for a successful perioperative outcome. Regional anesthesia using paravertebral block (PVB) provides an excellent alternative to GA in HOCM patients undergoing carcinoma breast surgery. We hereby describe the perioperative management of three patients of HOCM, with PVB as the preferred anesthetic modality, which resulted in excellent intraoperative conditions with adequate postoperative analgesia and negligible hemodynamic alterations. block. Bedside 2D by Assessment protocol revealed concentric LVH with hypertrophy, with LVEF of 70%, and turbulent across the AV valve. The case was then evaluated by a","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"322 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132669563","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":"Pandrug-resistant Infections","authors":"Dr Novy Gupte, S. Pradhan","doi":"10.5005/jp-journals-10070-0065","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0065","url":null,"abstract":"Ab s t r Ac t Background: Increasing antibiotic resistance, usually from irrational pharmacotherapy, poses a grave challenge to clinicians in managing multidrug-resistance infections. Aim and objective: To focus attention on the rising incidence of pandrug-resistant infections, related issues and concerns, and their containment. Materials and methods: The short communication is prompted by the recently reported in vitro sensitivity of gram-negative bacteria to a combination of ceftriaxone + sulbactam + EDTA. Appropriate observations from literature are cited to complement the outcome of the said study. Results: Pandrug resistance (PDR) is defined as a non-susceptibility of the bacteria to all antimicrobial agents in all antimicrobial categories. This is not true that it is restricted to only gram-negative bacteria. Staphylococcal aureus, a gram-positive bacteria, may too develop such resistance. The in vitro sensitivity observations do not necessarily get reflected in actual clinical effectiveness and efficacy. Therapy is a herculean task. Judicious use of antibiotics and strict infection control measures, preferably as a part of an antibiotic stewardship program, are mandatory to reduce the prevalence of PDR, nay the drug resistance as such. Conclusion: Pandrug resistance, meaning resistance to all classes of antibiotics, can develop not only in the case of gram-negative bacteria but also gram-positive bacteria, like S. aureus. It is best prevented rather than treated. Clinical significance: Implementation of the antibiotic stewardship program, mainly comprising rational antibiotic therapy, has the potentials to go a long way in safeguarding against PDR, nay antibiotic resistance as such.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116021958","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":"Perception about Virtual Endocrine Training among Endocrine Residents","authors":"Naresh Bansal, N. Kotwal, Sandeep Kumar, R. Malhotra, K. Brar","doi":"10.5005/jp-journals-10070-0067","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0067","url":null,"abstract":"Background: COVID-19 has jolted the world order with the disruption of education at all levels. Present disruption in medical education has opened doors to virtual platforms. There is a dearth of studies, evaluating the perception of medical students about virtual learning. We have conducted a cross-sectional study to understand the perception of endocrinology residents with regard to virtual training. Materials and methods: This study is a cross-sectional online survey done in April 2020. A total of 46 endocrine residents, participated in this survey. Total 05 questions were asked in this survey, whether they believe virtual endocrine training is required in present COVID-19 times or not, the format of training, method of teaching, preferred topics requiring coverage, and online assessment. Results: All 46 (100%) participants agreed with the need for virtual endocrine teaching. Of the total 46 participants, their seniority of endocrine training was 1st year ( n = 21, 45.65%), 2nd year ( n = 17, 36.96%), and 3rd year ( n = 8, 17.39%). Most preferred topics were endocrine imaging ( n = 9, 19.57%) and nuclear medicine ( n = 9, 19.57%) with pituitary as least preferred ( n = 1, 2.17%). Of the total, 50% of residents wanted virtual faculty lectures, 47.8% opted for virtual clinical case discussions. Out of 46, 97.8% of residents wanted virtual platform informal assessment of students. There was no statistical significance between the choice of a topic among different endocrine residents according to the seniority of their training. Conclusion: Our study has shown that there is a felt need for virtual training among endocrinology residents in India. Imaging and nuclear studies are the specific topics that endocrine students want to learn through faculty lectures, irrespective of seniority as endocrine students. This study can be used while planning virtual endocrine curriculums in the future.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"276 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117342248","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":"Medical Students’ Perception of Educational Environment and Effect of COVID-19 Pandemic on Learning","authors":"Tehmina P Syed, Samar Faheem, Shabnum Hassan","doi":"10.5005/jp-journals-10070-0068","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0068","url":null,"abstract":"Aim and background: The educational environment of students plays a vital role in their well-being and academic performance. Evaluating it is of crucial concern while looking for areas of improvement. The Dundee Ready Educational Environmental Measure (DREEM) is one of the most suitable tools to evaluate the educational environment for health training settings. The coronavirus disease-2019 (COVID-19) pandemic has made online teaching commonplace and changed how traditional medical education is imparted, making the assessment of students’ perception of the environment especially necessary. Materials and methods: Final year medical students in Hamdard University were given a questionnaire to fill after an exam, which included the DREEM survey and open-ended feedback and suggestion questions about their experience learning during the COVID-19 pandemic. For the DREEM survey, the positive Likert scale items were scored from 0 to 4, and the negative items were scored in reverse. The data were analyzed using SPSS 26.0 software. For the analysis of open-ended responses, common themes were identified and grouped. Results: A total of 93 completed questionnaires were received. The mean total DREEM score was calculated as 119.85 ± 37.86. It was more positive than negative but had a high standard deviation. Student’s perception of teachers scored the lowest, with a mean percentage of 55.25%. Student’s academic self-perceptions scored the highest with 65.06%. The open-ended responses were grouped into five themes, with only nine students saying their online learning experience was positive. Conclusion: This study revealed that most students of Hamdard University scored their educational environment positively but do not enjoy online classes. For the future, medical schools need to improve the teacher–student interaction and have a more empathetic approach toward students. Medical schools also need to work on a more engaging teaching style, which includes adapting new methods for online teaching.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114099132","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":"Epidemiological Profile of In-Hospital Deaths in a Tertiary Health Care Centre: A 3-Year Retrospective Study in Western Maharashtra","authors":"S. Chourasia, Shivani Dhaka, R. Rautji, K. Radhakrishna","doi":"10.5005/JP-JOURNALS-10070-0054","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10070-0054","url":null,"abstract":"\u0000\u0000\u0000The knowledge of specific contributors to mortality is crucial for the improvement of health of the community. Globally, medical certificate of cause of death is used for gathering epidemiological statistics. Our study examines the mortality pattern with sociodemographic characteristics of in-hospital deaths, which occurred at a tertiary health care center in Maharashtra.\u0000\u0000\u0000\u0000This study is a descriptive retrospective study in which 1,000 medical certification of cause of death forms (n = 1000) filled at a tertiary care hospital between Aug 2016 and Aug 2019 were analyzed.\u0000\u0000\u0000\u0000Total 64.5% of cases were males and 35.5% were females. About 42% were elderly (60–80 years). About 23% of the deaths were due to “diseases of the circulatory system.” The highest number of cases died within the first 10 days of admission. The “diseases of circulatory system” was the commonest group causing deaths in “brief” hospital stay ((<10 days), “diseases of digestive system” in “short” (10 days–1 month), “neoplasia” in “long” (1–3 months), and “diseases of nervous system” in “prolong” hospital stay (>3 months).\u0000\u0000\u0000\u0000The mortality rate among males was more than twice of females and maximum deaths were observed in the geriatric age group. The chief causes of mortality overall and among both males and females individually were the diseases of the circulatory system among which, the cerebrovascular diseases accounted for highest number of cases. Overall demographic data were comparable to observations from various national and international studies.\u0000\u0000\u0000\u0000Cause-specific mortality statistics are routinely required by policy makers, researchers, and other professionals for decision-making for resource allocation, monitoring of health indicators, and identifying priorities for health initiatives. Availability of data remains limited and inadequate in many countries. Studies on in-hospital deaths are needed to identify mortality indicators in different regions and channel public health initiatives in the right direction.\u0000\u0000\u0000\u0000Chourasia S, Dhaka S, Rautji R, et al. Epidemiological Profile of In-Hospital Deaths in a Tertiary Health Care Centre: A 3-Year Retrospective Study in Western Maharashtra. J Med Acad 2020;3(2):38–42.\u0000","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125546727","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":"Aerobic vs Resistance Exercise—An Endocrine Perspective","authors":"Naresh Bansal, N. Kotwal, Sandeep Kumar","doi":"10.5005/jp-journals-10070-0057","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0057","url":null,"abstract":"Exercise elicits a wide variety of hormonal responses critical for metabolism and consequent tissue growth and development. It is imperative to understand that when we exercise there are acute endocrine responses and subsequent chronic endocrine conditioning. The acute response depends upon the frequency, intensity, and duration of physical exercise. Chronic endocrine conditioning is attained after a long duration of exercises and the magnitude of this conditioning is dependent on persistence, duration, attainment of neuroendocrine responses, and skeletal muscle response which releases myokines. There is ample amount of evidence now to believe muscle as an endocrine organ. Exercise activates various molecular mechanisms in the muscle which alters various endocrine and metabolic milieu inside the muscle. This review aims to provide evidence-based narration of peculiar anabolic and catabolic hormonal responses to exercise and revisit the mechanistic explanation of this occurrence. This review has analyzed the differential endocrine adaptation in aerobic and anaerobic exercises.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115480213","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":"Venous Air Embolism due to Hydrogen Peroxide during Anal Fistulectomy under Saddle Block","authors":"V. K. Singh, A. Nasser","doi":"10.5005/jp-journals-10070-0045","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0045","url":null,"abstract":"Hydrogen peroxide (H 2 O 2 ) is used by surgeons due to its oxygen releasing effervescent properties to locate internal openings in fistulous tracts. The oxygen released is known to cause embolism when it enters venous circulation, particularly when it is forced into a closed cavity. The obstruction it causes to the blood flow can cause circulatory and ventilatory failure. It manifests clinically by rapid fall in EtCO 2 , hypotension, rise in central venous pressure (CVP), and fall in oxygen saturation. We present a case of a male patient who underwent fistulectomy under a saddle block and later developed air embolism when H 2 O 2 was forcefully pushed at the site of surgery.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132295278","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":"Eschar in Scrub Typhus: A Case Series","authors":"N. Verma, N. Mahesh, Sandeep Thareja, N. Issar, K. Ashta, D. Salimath","doi":"10.5005/jp-journals-10070-0044","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-0044","url":null,"abstract":"Ab s t r Ac t Introduction: Scrub typhus is endemic in eastern and southern Asia, islands of western Pacific and Indian Ocean. The causative organism is a gram-negative bacterium, Orientia tsutsugamushi. Eschar in scrub typhus helps in early diagnosis and treatment, however the eschar positivity rates vary greatly. An eschar in an acute febrile patient from tsutsugamushi triangle is an important sign. The presence of eschar and IgM ELISA positivity can be used to detect majority of scrub typhus cases. Materials and methods: It is a hospital based observational study. This study state the epidemiologic and clinical profile of eight scrub typhus positive patients who were admitted in Base Hospital Delhi Cantonment (BHDC) during August–October 2018. Case series and result: Fever was the chief presenting complaint among all patients. Five patients had associated myalgia, headache and two patients had abdominal pain. One patient had cough and breathlessness which required intensive care. Eschar, the pathognomic feature of scrub typhus was present in all cases. Overall, the most common area of an eschar was groin followed by the abdomen. Conclusion: Presence of eschar is the key to clinical diagnosis of scrub.","PeriodicalId":223367,"journal":{"name":"Journal of Medical Academics","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123510281","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}