Journal of Marine Medical Society最新文献

{"title":"Real-Life Experience of Safety Profile of a Rituximab Biosimilar (Reditux®) in Patients at a Rheumatology Center in India","authors":"R. Singh, Vivek Vasdev, S. Bhatt, Ashwani Kumar, Abhishek Kumar, Kaushik Roy","doi":"10.4103/jmms.jmms_177_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_177_23","url":null,"abstract":"\u0000 \u0000 \u0000 The aim of this study was to study the safety profile of a rituximab (RTX) biosimilar Reditux® in patients of rheumatological disorders at a tertiary care hospital in North India.\u0000 \u0000 \u0000 \u0000 An observational study was carried out to ascertain the safety of RTX in rheumatology patients. A total of 60 patients initiated on RTX were followed up for a mean duration of 14 months for adverse events.\u0000 \u0000 \u0000 \u0000 A total of seven mild infusion reactions were recorded during the first infusion of RTX. Eighteen infective events were recorded including a case of extrapulmonary tuberculosis (TB), three cases of hepatitis B virus (HBV) reactivation, four cases of herpes zoster, and a fatal case of disseminated varicella infection. There were no cases of JC virus infection or malignancies in our study.\u0000 \u0000 \u0000 \u0000 This study highlights a much higher incidence of infections following the use of RTX in India as compared to international studies published so far. We also observed a higher rate of reactivation of HBV, varicella zoster virus, and TB in our cohort. This emphasizes the need for revising protocols for screening, vaccination, and chemoprophylaxis for chronic infections in countries with high burden of infections.\u0000","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370439","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":"Cultural Competency Training in Medical Education: Adopting a Multipronged Approach to Overcome Challenges","authors":"S. Shrivastava, P. Bobhate, H. Mendhe, Yugeshwari Tiwade","doi":"10.4103/jmms.jmms_173_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_173_23","url":null,"abstract":"\u0000 The domain of cultural competency in medical education deals with the varied cultural backgrounds and specific needs of different patients who are accessing health-care delivery services. The training in cultural competency imparted to medical students augments their knowledge and makes them aware of the presence and role of cultural, ethnic, and socioeconomic diversity in heterogeneous population groups. It is quite essential that training of medical students to become culturally competent must be conducted across all professional years of training in a longitudinal manner. Even though there are multiple benefits of training medical students in the domain of cultural competency, once we plan and implement such training, there can be multiple challenges. In conclusion, as medical education continues to evolve to meet the health-related needs of diverse population groups, cultural competency has to be acknowledged as one of the foundational pillars in empowering future cohorts of health-care professionals to deliver inclusive and culturally sensitive patient-centered medical care. The need of the hour is to identify the potential challenges in its successful implementation and then adopt a multipronged approach to effectively respond to them.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370666","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":"Comparison of Xpert MTB RIF (G4) With Xpert MTB (Ultra) in Diagnosis of Mycobacterium Tuberculosis in Clinical Samples","authors":"Ann Mathew, Puneet Bhatt, Sandeep Madhav Ninawe, Ankita Patel, Ashish Bahal","doi":"10.4103/jmms.jmms_156_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_156_23","url":null,"abstract":"\u0000 \u0000 \u0000 Tuberculosis (TB) continues to be a major cause of morbidity and mortality worldwide. The main strategy to fight the pandemic is the development of rapid, accurate diagnostic tests, which helps to reduce the time for initiation of therapy. In 2010, WHO recommended the use of Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) (G4), which is a cartridge-based semi-automated nucleic acid amplification test (NAAT) as a primary test with an aim to improve the detection of MTB. Later on, to improve the diagnostic efficacy, the new and improved cartridges called Xpert Ultra were introduced in 2017.\u0000 \u0000 \u0000 \u0000 One thousand and sixty-nine clinical samples were utilized for the study for microscopy, culture, and NAATs (Xpert MTB/RIF G4 and Ultra). The samples were randomly allocated. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated while assuming trace results as positive and negative in two separate scenarios.\u0000 \u0000 \u0000 \u0000 The sensitivity of Xpert MTB/RIF Ultra cartridge was higher (100%) than Xpert MTB/RIF G4 cartridge (95.23%) and the specificity of Ultra cartridge was lower (71.79%) when compared to G4 cartridge (91.63%). However, the specificity of Xpert Ultra cartridge improved by reclassifying the “trace” interpretation as negative (89.1%). The NPV was 100% and 99.09% for Xpert Ultra cartridge and the Xpert G4 cartridge, respectively, and did not change by reclassifying the “trace” interpretation as negative. In contrast, the PPV varied greatly between the two tests, 26.66% for Xpert Ultra cartridge and 66.66% for Xpert G4 cartridge. The PPV of Xpert Ultra cartridge was improved to 48.48% by including “trace” samples in the negative pool.\u0000 \u0000 \u0000 \u0000 Xpert Ultra and G4 shows good performance as a first line diagnostic test. Caution should be exercised when interpreting ‘trace’ results in a country like India without parallel confirmatory tests like microscopy and culture. Data is limited on this newly incorporated value assigned in the automated report. Conducting further studies on results interpreted as ‘trace’ will help in improving the guidelines and as well as utilisation of such tests.\u0000","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369067","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":"Characteristics the Living, Working Conditions, and Nutrition of Seafarers Working on Transoceanic Ships: A Cross-sectional Study","authors":"Ha Nguyen Thị Hai, Nam Nguyen Bao, Son Nguyen Truong, Tam Nguyen Van","doi":"10.4103/jmms.jmms_152_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_152_23","url":null,"abstract":"\u0000 \u0000 \u0000 Seafaring is a particularly strenuous and hazardous profession. When sailing at sea, the ship is both a living place and a working place for the seafarers. Working conditions at sea are extremely difficult, they often have to work in harsh conditions of nature and workers have to suffer loneliness, isolation from the mainland. The aim of this research is to describe the living, working conditions, and nutrition of seafarers working on transoceanic ships.\u0000 \u0000 \u0000 \u0000 Four hundred Vietnamese crew members working on 21 ocean freighters docked at Hai Phong and Cai Lan ports in Quang Ninh province, Vietnam in 2021. Using cross-sectional, descriptive, epidemiological methods through observation and measurement of the room area, the area of the gym, the equipment for exercise on the ship of the crew; direct interviews with all crew members about living, working and nutritional conditions on board: Recreational conditions; physical training; drink beer, wine; smoke; shiftwork; time a sea trip; micro-social environment on board; the crew’s nutrition.\u0000 \u0000 \u0000 \u0000 Micro-social environment on board (100% male), 100% crew working in shifts work; the living room and the gym room are narrow; monotonous, boring life, poor cultural and spiritual activities; inadequate and lack of exercise equipment. 61.5% of crew members smoke; 48.7% of seafarers do not exercise, 32.5% exercise infrequently, 18.8% exercise regularly; 88.7% of seafarers drink alcohol, of which 22.5% of seafarer’s abuse alcohol. The crew’s nutrition is unreasonable and unbalanced, excess protein, lipid, and lack of green vegetables: Unreasonable diet (79.2%); excess energy diet (68.8%); diets high in protid (58.5%), high in lipids (54.8%), unbalanced in the ratio of animal/vegetable protid (50.2%), and lack of fiber (79.2%).\u0000 \u0000 \u0000 \u0000 The living and working conditions of crew members are still difficult and not guaranteed. Improper and unbalanced nutrition, excess protein, and lipid but lack of fruit and fiber.\u0000","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372270","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":"The Role of Magnetic Resonance Spectroscopy, Magnetic Resonance Perfusion and Positron Emission Tomography-Computed Tomography in Post-Radiotherapy Evaluation of Gliomas to Detect Recurrence","authors":"Sachin Taneja, A. Sarin, Kirti Tyagi, M. Semwal, Deboleena Mukherjee, H. Sidhu, Sougat Ray","doi":"10.4103/jmms.jmms_158_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_158_23","url":null,"abstract":"\u0000 \u0000 \u0000 In this article, the findings of magnetic resonance spectroscopy (MRS), magnetic resonance (MR) perfusion, and positron emission tomography (PET) will be compared and finally correlated with the histopathological examination in all patients having positive imaging findings. The sensitivity and specificity of MRS, MR perfusion, and PET in diagnosing residual/recurrent glioma would be estimated using the histopathological diagnosis as a gold standard.\u0000 \u0000 \u0000 \u0000 Twenty-nine cases of intracranial glioma that had undergone surgery, followed by adjuvant radiotherapy were enrolled in the study. All 29 patients underwent MRS, MR perfusion, and fluorodeoxyglucose (FDG) PET.\u0000 \u0000 \u0000 \u0000 The sensitivity of MRS to detect recurrence was found to be 83.3% and specificity was 100%. The positive predictive value (PPV) and negative predictive value (NPV) were 100% and 33.3%, respectively. The diagnostic accuracy of MRS was found to be 84.6%. The sensitivity and specificity of MR perfusion to detect recurrence were 91.7% and 100%, respectively. The diagnostic accuracy of MR perfusion is 92.3%. The NPV of MR perfusion was found to be 50%. The sensitivity of PET scans to detect recurrence was 83.3% and specificity was 100%. The PPV of PET was 100% and the NPV was 33.3%. The diagnostic accuracy of the PET scan was found to be 84.6%.\u0000 \u0000 \u0000 \u0000 Our study shows that all three modalities are useful, however, MR perfusion study is better than MRS and FDG PET in detecting recurrence. MR contrast with perfusion and spectroscopy and FDG PET scan should be included in the protocol for radiotherapy-treated gliomas to differentiate between radiation necrosis, postradiotherapy gliosis, and recurrent/residual tumor.\u0000","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373139","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":"Hand Injuries Onboard an Aircraft Carrier – A Case Series","authors":"Akil A. Kalathil, Yogeshwar Balasaheb Surse","doi":"10.4103/jmms.jmms_143_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_143_23","url":null,"abstract":"\u0000 Hand injuries comprise a large part of all the injuries coming to the emergency department of the hospitals. Being the most important asset to man after the brain, any injury to the hands can cause lasting consequences. The importance of gross and fine motor skills of hands can hardly be stressed upon. The cases although common in a general scenario are not easily managed onboard a mobile platform with limited resources in terms of expertise, equipment, and manpower. In this case series, we describe the management of five injuries which took place onboard an aircraft carrier during sailing over a period of 9 months.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370555","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":"Imerslund–Grasbeck Syndrome – A Rare Encounter!","authors":"Rajiv Kumar, Preeti Tripathi, Sanjeev Khera, J. Bhatia","doi":"10.4103/jmms.jmms_182_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_182_23","url":null,"abstract":"","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140409445","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 Comparative Study of the Efficacy of Platelet-rich Plasma Therapy versus Topical Application of 0.1% Tretinoin Gel in the Management of Striae Gravidarum","authors":"Reetu Agarwal, Ajay Chopra, Anant Oberoi, Loknandini Sharma, Padmapriya Srinivasan","doi":"10.4103/jmms.jmms_92_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_92_23","url":null,"abstract":"\u0000 \u0000 \u0000 To determine the relative efficacy of platelet rich plasma therapy versus topical 0.1% tretinoin gel in the management of striae gravidarum.\u0000 \u0000 \u0000 \u0000 To determine the degree of response to platelet rich plasma therapy in comparison with topical 0.1% tretinoin gel in striae gravidarum and to determine the treatment of choice amongst platelet rich plasma and topical 0.1% tretinoin gel.\u0000 \u0000 \u0000 \u0000 Study design - A randomised control cross sectional comparative study among the female patients with striae gravidarum was carried out at department of Dermatology, Venereology & Leprosy, Base Hospital, Delhi Cantt, New Delhi.\u0000 \u0000 \u0000 \u0000 There was early and fast clinical improvement in PRP group with continuous clinical improvement noticed in successive sittings although degree of improvement was lower in 5th and 6th sittings. There was also an earlier plateau of response, in tretinion group after 04 sittings with mild or little improvement in the last 02 sittings in comparison to the PRP group.\u0000 \u0000 \u0000 \u0000 Platelet Rich Plasma therapy was effective as compared to topical 0.1% Tretinoin gel in the management of Striae gravidarum. PRP had better treatment outcome as well as patient satisfaction.\u0000","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410006","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":"Impact of Smoking in Postoperative Outcomes after Elective Surgery","authors":"Vishal Goyal, Chaitanya K Varma, Mahesh Behera, G. P. Reddy, Mamadur M. Ram Shankar","doi":"10.4103/jmms.jmms_150_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_150_23","url":null,"abstract":"\u0000 \u0000 \u0000 The hazard of smoking is not only limited to the general health risks but also makes the smokers more vulnerable to various perioperative complications ranging from pulmonary complications to delayed wound healing to cardiovascular events.\u0000 \u0000 \u0000 \u0000 This is an observational study in the department of general surgery of a tertiary care teaching hospital over a period of 24 months (May 2019–April 2021). Patients between 18- and 60-year age undergoing noncardiac elective surgical procedures were included in the study.\u0000 \u0000 \u0000 \u0000 A total of 240 patients, meeting the inclusion criteria, posted for elective, noncardiac surgery were enrolled in this prospective observational study. In smoker patients’ group (n = 138) undergoing surgery, 42 (30.4%) patients developed postoperative complications as compared to 12 (11.8%) patients in nonsmoker group (n = 102). The risk of postoperative complications among smokers was 3.2 times (odds ratio [OR], 95% confidence interval [CI]: 1.62–6.63) (P ≤ 0.0009). Smokers with pack-years > 11 had 3.8 times increased risk of postoperative complications as compared to nonsmokers (OR, 95% CI: 1.85–8.098) (P ≤ 0.0003).\u0000 \u0000 \u0000 \u0000 Our study aims to add to existing evidence and improve our understanding of delayed wound healing and major complications in smoker patients as surgical cases. Nonsmokers are at a lesser risk than smokers in postoperative complications. Awareness regarding the harmful effects of smoking and its influence on postoperative wound healing, motivation for quitting, and abstinence from smoking will help in reducing postoperative complications and better treatment outcomes.\u0000","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140408609","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":"Holmium Laser Lithotripsy in the Management of Difficult Biliary and Cystic Ductal Stones – A Case Series","authors":"Amit Kumar, H. Goje, N. K. Tarway, V. Hande","doi":"10.4103/jmms.jmms_176_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_176_23","url":null,"abstract":"\u0000 Choledocholithiasis or common bile duct stone (CBDS) presents a unique challenge in the management of biliary stones. The clinical presentation of CBDS varies from asymptomatic CBDS, detected during the evaluation of gallstone disease to sinister presentation, like severe biliary pancreatitis. Asymptomatic liver function test abnormality, biliary colic, dilated common bile duct (CBD) on sonography for pain abdomen, and cholangitis are the part of the spectrum. Based on clinical suspicion and aided by laboratory parameters, the diagnosis is confirmed by modalities such as ultrasonography or magnetic resonance cholangiopancreatography or by endoscopic ultrasound. Endoscopic radiological cholangiopancreatography (ERCP) has evolved as a standard of care over the decades for the management of CBDS and surgical exploration of CBD is rarely resorted. ERCP is followed by laparoscopic cholecystectomy as a definitive treatment to prevent recurrence of CBDS. Multiple factors play a role in the successful extraction of CBDS. Two broad considerations are the size of stone and bilio-duodenal anatomy. Multiple studies have noted that stone size larger than 15 mm requires fragmentation for successful extraction. Mechanical lithotripsy has been cornerstone for the management of such cases. Besides size of stone, morphology and number of stones, narrow CBD (distal to stone), duodenal diverticulum and altered anatomy due to gastroduodenal surgeries pose a challenge in stone extraction and are collectively called difficult CBDS. Multiple modalities notably extracorporeal shortwave lithotripsy, holmium laser (Ho laser) lithotripsy, and electrohydraulic lithotripsy (EHL) have been studied for the fragmentation of large CBDS. Innovation in cholangioscopy and wider availability of peroral single-operator cholangioscope has brought EHL and Ho laser lithotripsy (LL) at forefront of management of difficult CBD stones. We share the experience of Ho LL for CBDS at a tertiary care hospital in Western India. The data of four patients, successfully managed with single-operator cholangioscopy (SoC)-guided Ho LL for indications ranging from large CBDS to residual large cystic duct stump stone has been discussed. These cases emphasize wider clinical application of SoC-guided Ho-LL beyond the size of the stone. Ho LL has revolutionized the management of difficult biliary stone. The major limitation is cost of care and availability of expertise.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410762","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}