MAMC Journal of Medical Sciences最新文献

{"title":"Six Sigma metrics as an indicator for Randox International Quality Assessment Scheme in clinical biochemistry laboratory: A pilot study with thyroid function test in a tertiary care hospital","authors":"Neeraj Yadav, M. Meena, Shailata Prisi, Aditi Singh, Ritu Singh","doi":"10.4103/mamcjms.mamcjms_12_23","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_12_23","url":null,"abstract":"Context: Six Sigma methodology represents an evolution in quality assessment and management that has been implemented widely in industry and health sector since the mid-1980s. It consists of five steps: define, measure, analyze, improve, and control (DMAIC). Randox International Quality Assessment Scheme (RIQAS) program Target Score (TS) is a performance indicator, and Sigma metrics is considered as a gold standard for overall performance. Aim: The aim of this study is to present the TS and Sigma metrics observed in clinical chemistry laboratory in SSK Hospital associated with Lady Hardinge Medical College to evaluate the analytical performance of T3, T4, and thyroid-stimulating hormone (TSH) parameters. The study period is from June to August 2022. Materials and Methods: The Sigma metrics for the various analytes was calculated by the following equation: Σ = TEa − bias/CV (TEa—total allowable error, CV—coefficient of variation). Acceptable performance criteria: standard deviation index (SDI) <2; TS >50; the closer a value is to 120, the better the performance, <40 is unacceptable; and %deviation should be less than the defined acceptable limits which is unique to each analyte, the closer the value is to zero, the better is the performance. Results: Our RIQAS results lie in acceptable range except for T3 in the month of August in which TS was unacceptable. Our laboratory Sigma metrics were below three sigmas. The findings of our exercise emphasize the need for a detailed evaluation, and we promote the use of Sigma metrics in quality assurance in the best interest of the patient. Conclusion: Quality check strategies were applied according to the TS and sigma values.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","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":"42270145","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":"Assessment of Periodontal Status in the Patients with Chronic Obstructive Pulmonary Disease (COPD)","authors":"Shanta Shree, Rehbar Khan, V. Pathak, A. Pandey, A. Verma, Devendra Singh","doi":"10.4103/mamcjms.mamcjms_17_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_17_22","url":null,"abstract":"Background: Oral infections, especially periodontal diseases, may affect the course and pathogenesis of a number of systemic diseases including respiratory diseases. The current study aimed to determine the periodontal status in the patients with chronic obstructive pulmonary disease (COPD). Materials and Methods: The study consisted of 65 COPD patients (case) and 65 healthy individuals (non-COPD). Individuals in the case group were well-functioning, ambulatory patients having COPD as determined by their history, clinical examination, and spirometry. Periodontal status was evaluated by the indices, namely, simplified oral hygiene index (OHI-S), plaque index (PI), gingival index (GI), pocket probing depth (PPD), and clinical attachment level (CAL) in both the groups. Results: In the studied population, the mean (± standard deviation, SD) age was higher in COPD group (50.3 ± 11.4) compared to the control group (41.9±8.1; P < 0.0001). In the COPD group, average smoking index was 369.3 ± 167.2, while in control group, it was 323.88 ± 132.8 (P = 0.889). Our data show that individuals in the COPD group had significantly higher OHI-S, PI, GI, PPD, and CAL (P < 0.0001) compared with the control group. The mean score of OHI-S, PI, GI, PPD, and CAL was higher in moderate and severe COPD patients compared to mild COPD patients; however, this difference was not statistically significant. Conclusion: The patients with COPD showed poor oral hygiene and a higher prevalence of periodontal disease. Prevention and treatment of periodontal disease could be included in the planned intervention campaigns designed to help patients with COPD.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46496101","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":"COVID-19 Biomedical Waste Management Practices among Medical Professionals in a Tertiary Hospital: Need for Safe and Sustainable Methods","authors":"A. Afsar, L. Bains, A. Mishra, Akshit Mittal, S. Aggarwal, Daljit Kaur","doi":"10.4103/mamcjms.mamcjms_60_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_60_22","url":null,"abstract":"Context: The Coronavirus Disease 2019 (COVID-19) pandemic that began in 2019 has affected more than 232 million people around the world with over 4.7 million deaths as on September 30, 2021. Amidst the crisis, there has been increased generation of biomedical-waste (BMW). In April 2021, a 62% rise was observed compared to 123 metric tonnes of waste generated in February 2021. The hospital waste mismanagement has diverse ramifications as it affects the patients, healthcare workers (HCWs), public, environment, and economy. Proper BMW management aims to reduce generation, ensures efficient collection, handling and safe disposal so that it controls infection and improves safety. Aims: The present study was conducted to assess the knowledge among medical professionals regarding BMW segregation, transport, and treatment. Settings, Design, Methods, and Materials: A google formed based survey was done to assess the knowledge regarding management of COVID-19 BMW among HCWs (MBBS students, residents, and consultants) associated with tertiary care hospitals of North India. Results: The knowledge score was : for segregation − 27.4%, 59.6%, and 49.8%; transport from site of generation to site of disposal − 63.6%, 89.1%, and 95.2%; disposal − 29%, 71.9%, and 68.2%; overall score − 41.4%, 67.9%, and 61.3% among the students, residents, and consultants respectively. We found that participants with greater years of experience (residents and consultants) had better knowledge as compared to that of the students (P = 0.032). Conclusion: We found a mean score of 56.9% which is more than that of few low- and middle-income countries but less than that of European countries. The chances of infection directly correlate with lower knowledge score. Appropriate evidence-based, judicious use of PPE as per the settings and guidelines should be followed. Training aspects, periodic evaluation, and assessment should be strengthened, both for practising medical professionals and for students, to ensure a safe and sustainable healthcare system.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47691196","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 between Levels of Vitamin D and Disease Severity and Outcome in COVID 19 Patients at a Tertiary Hospital in North India","authors":"T. Ghosh, R. Krishnan, Souradeep Chowdhury, Arvind Kumar, U. Baitha, Shweta Sharma, N. Wig","doi":"10.4103/mamcjms.mamcjms_32_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_32_22","url":null,"abstract":"Introduction: COVID-19 disease is more prevalent and severe in people who are more likely to be deficient in vitamin D, people with obesity and diabetes mellitus, and people who live in higher latitudes. Materials and methods: The study was an ambispective, analytical, observational study conducted at a tertiary care teaching hospital in New Delhi, India. The study population consisted of adults with a confirmed diagnosis of COVID-19. Results and conclusion: Eighty eight patients diagnosed with COVID-19 between February and July 2021 were enrolled, with mean (SD) age being 40(2) years and there were 55 (62.5%) males. The most common co-morbidities were hypertension, diabetes mellitus, and chronic obstructive pulmonary disease (COPD) and the most common symptoms were fever, cough, and myalgia. Twelve (13.6%) patients had severe disease. Seven (7.9%) patients died. Sixty one (69.3%) patients had vitamin D levels <30 ng/mL and had severe disease, more symptoms, and increased oxygen requirement, but did not affect laboratory parameters and mortality.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44407652","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 Mobile Phones in Patients with Stroke","authors":"Alvina, Adithya Paul, A. Faruqui","doi":"10.4103/mamcjms.mamcjms_51_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_51_21","url":null,"abstract":"Objectives: There is a paucity of systematic studies conducted to get information on the impact of mobile phone radiation on health. This pilot study was done to explore the use of mobile phones in patients with stroke. Methods: This cross-sectional study used a structured questionnaire among stroke patients in a tertiary hospital in India. We collected demographic details, history, and information on their mobile phone type, usage, and specific absorption rate (SAR) value. We used descriptive statistics to report our findings. Results: This group of 50 stroke patients was predominantly an urban population (78%) with a higher number of male subjects (56%); a higher prevalence of ischemic stroke (76%); 30% were smokers; with comorbidities of hypertension (75%) and diabetes (46%), a significant proportion of whom were not on regular treatment 64% and 74%, respectively. More number of patients used feature phones (82%). The median (SAR) value of all phones was 0.81 W/kg. Hypertension was present in patients who had contact with the phone for >5 hours (78%), subjects who kept their phone closer to the pillow while sleeping (71%), and those carrying a phone in their pockets or on self for >5 hours (80%). Conclusion: This group of patients had predominantly ischemic stroke; a significant proportion having hypertension and diabetes were not on regular treatment and were smokers. Cases of hypertension were noted to be higher in patients with increased exposure to mobile phone radiation. As a pilot study with limitations of a small number of patients, these findings could be only incidental. Further research is required to make any conclusions.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44058337","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":"Tubercular osteomyelitis as scalp swelling and alopecia areata","authors":"A. Bhatia, P. Verma, Ashok Singh","doi":"10.4103/mamcjms.mamcjms_14_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_14_22","url":null,"abstract":"Tuberculosis (TB) is a well-known endemic disease in developing countries. It continues to be one of the major causes of death and disability in such countries. However, extrapulmonary TB is less common than pulmonary TB. Skeletal TB constitutes about 1% of all tubercular cases. Tubercular osteomyelitis of skull is a rare entity. The most common sites affected are the frontal and parietal bones with destruction of both the inner and outer table. We hereby report a young male presenting to us with scalp swelling in the left frontal region with loss of hair in surrounding areas and in left temporal region. NCCT head was suggestive of osteolytic lesion in frontal bone on left side with accompanying periosteal reaction, consistent with osteomyelitis. In Gene Xpert of pus drained from the swelling, Mycobacterium tuberculosis was detected. Patient was started on Antituberculous treatment, and subsequently improved.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41958601","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":"Tuberculous and Nontuberculous Lesion of Lymphnodes − Histopathological and Cytological Correlation","authors":"D. Patel, Jignasa N. Bhalodia, Shraddha Patel","doi":"10.4103/mamcjms.mamcjms_47_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_47_22","url":null,"abstract":"Background: The lymph node is one of the major anatomic components of the immune system. Lymph nodes are the most widely distributed and easily accessible component of lymphoid tissue and hence they are frequently examined for diagnosis of lymphoreticular disorders. Lymph node swellings are one of the commonest clinical presentation of patients and it encompasses a wide spectrum ranging from inflammation to a malignant lymphoma or a more obnoxious metastatic malignancy. Aims and objectives: The aim of this study is to evaluate the diagnostic accuracy of Fine Needle Aspiration Cytology (FNAC) in correlation with histopathology in cases of cervical lymphadenopathies. Material and methods: Patients referred to the Department of Pathology, GMERS Medical College and Hospital, Sola Ahmedabad for period of 12 months from June 2021 to May 2022 for palpable lymph node swelling on whom FNAC procedure was performed were included in the study. FNAC diagnosis of patients was compared with histopathology in cases which underwent surgical excision and its diagnostic accuracy was studied. Results: Out of 100 cases which were included in the study, lymph node biopsy was carried out in all 100 cases. Most were in age group of 21 to 30 years. Gender wise, there was male preponderance. Benign lymphadenopathies were diagnosed in 93% of cases. Metastatic deposits were diagnosed in 7% of cases. On correlation of FNAC findings with histopathology, overall correlation rate was 85.2%. Conclusions: FNAC is especially helpful as lymphnode biopsy is a difficult and invasive procedure. Although excision biopsy is the gold standard, FNAC is preferred as first-line investigation.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46703653","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":"Pitfalls of Sanitizer Use in the COVID-19 Era: A Case Report of Hand Sanitizer-Induced Blindness due to Contamination by Methanol","authors":"S. Aggarwal, Sricharan Vijayakumar, R. Singh, B. Koner, R. Saijpaul, Naresh Kumar, Ankitesh Kumar, Tushar Mittal","doi":"10.4103/mamcjms.mamcjms_31_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_31_22","url":null,"abstract":"The COVID-19 pandemic has boosted the availability of hand sanitizers worldwide, which have become ubiquitous. Their widespread utility has also contributed to increased accidental or intentional sanitizer ingestion. We describe the case of a young male who presented with an unintentional ingestion of hand sanitizer. On examination, he had a depressed sensorium, and further evaluation revealed severe metabolic acidosis. The patient was suspected of ethanol toxicity and underwent hemodialysis with concurrent bicarbonate replacement. However, the presence of bilateral visual loss, characteristic Computed Tomography (CT) brain finding of hemorrhagic putaminal necrosis, and normal serum ethanol levels prompted a search for methanol in the sanitizer. Specific biochemical tests confirmed this for methanol, and a diagnosis of sanitizer-induced methanol poisoning was made.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45742744","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":"Patient-reported Outcomes of SARS-CoV-2 Positive Adult Orthopedic Trauma Patients Treated During the Ongoing Pandemic: An Experience from Single Center","authors":"V. Bajaj, Yasim Khan, Abhishek Kashyap, Bharat Ram Devajee, Saurabh Arora, S. Arora, V. Kumar, L. Maini","doi":"10.4103/mamcjms.mamcjms_25_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_25_22","url":null,"abstract":"Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has become a matter of concern all over the world. It has resulted in delay in surgery or, at times, preference for nonoperative treatment for SARS-CoV-2 positive orthopedically injured adult patients which may adversely affect the clinical outcomes. In this study, we report the outcomes of orthopedic adult trauma patients who tested positive for SARS-CoV-2 at admission. Methods: We retrospectively reviewed the prospectively collected data from the period between April 1, 2020 and December 31, 2020. We reviewed 521 out of total 2435 patients presenting in the casualty that required orthopedic trauma surgery. Thirty-eight out of total 521 patients, that tested positive for SARS-CoV-2, were followed-up using telecommunication for final outcome of fracture treatment. A telecommunication patient satisfaction score after injury (TPSSI) was used to evaluate the patient satisfaction. Results: The mean age was 37.94 years (range: 18–72 years). They were followed-up for mean duration of 8.18 months (range: 6–13 months). Out of total 38, 23 underwent orthopedic trauma surgeries and rest 15 were managed nonoperatively. There was a mean delay in surgery of 5 weeks (range: 3–12 weeks). Five patients lost their lives and seven others had nonunion. The median TPSSI score was three. Conclusions: Nonoperative and delayed surgical management of adult orthopedic trauma patients, who tested positive for SARS-CoV-2 at admission, result adversely in activities of daily living and return to original occupation and, thus, have poor patient satisfaction.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46577194","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":"Acceptance of COVID-19 Vaccine and Its Related Determinants Among the Residents of Western Uttar Pradesh","authors":"Aprajita Panwar, P. Tyagi, Apoorva Bhargava, R. Gupta","doi":"10.4103/mamcjms.mamcjms_9_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_9_22","url":null,"abstract":"Background and Objectives: Amidst multiple waves of the coronavirus disease 2019 (COVID-19) pandemic, numerous vaccines are being used worldwide to provide immunity against the coronavirus. Knowledge, attitudes, and perceptions of the community toward COVID-19 vaccination could influence vaccine acceptance. This study aimed to evaluate the knowledge, attitudes, and perceptions toward COVID-19 vaccination and assess its determinants. Material and Methods: A web-based cross-sectional study was conducted as a structured 27-item questionnaire through Google Forms. Qualitative data were processed by categorizing responses for an item according to intended objectives, and data were coded numerically. The associations between variables were explored by using a modified Poisson regression to determine adjusted prevalence ratios and their 95% confidence intervals. Results: The vaccine acceptance rate among the respondents was 72% and was more among those involved in the health care sector. The participants feared vaccine-related side effects and were less willing to accept the vaccination. The participants who believed adults also require vaccination against diseases accepted the COVID-19 vaccine. We found that the subjects with comorbid conditions, urban areas, and those who had contacted COVID-19 infection or family members were more willing to get vaccinated (P < 0.001). Conclusions: We concluded that a considerable majority (72%) of residents exhibit good vaccine acceptability. Health care providers, social media, and community influencers can design awareness campaigns to address perceived safety concerns and achieve a 100% acceptance rate in the community.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43084325","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}