National Medical Journal of India最新文献

{"title":"Recurrence of disease in a patient with Covid-19: Re-activation or re-infection?","authors":"Abhinav Shrivastava,&nbsp;Satyajit Padhiari,&nbsp;Rajnish Singh","doi":"10.25259/NMJI-35-3-165","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-165","url":null,"abstract":"<p><p>Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) was expected to induce a monophasic disease with subsequent immunity. However, case reports have since emerged which have found patients with either re-infection or re-activation of the virus. We describe a 44-year-old man with severe Covid-19-induced pneumonia who had recurrence of the disease after testing Covid-19-negative on three consecutive reverse transcriptase-polymerase chain reaction (RT-PCR) tests. Our patient underlines that caution should be exercised while planning for discharge of a patient irrespective of his previous negative test, especially in vulnerable patients and those who had moderate-to-severe disease requiring the use of immunosuppressive therapy. The fact that such patients could experience a re-activation or re-infection, requires monitoring and vigilance in the management of the pandemic at individual and collective levels.</p>","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"165-167"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40547597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression, anxiety, stress and resilience among undergraduate health sciences students of a rural tertiary healthcare centre in Maharashtra during the Covid-19 lockdown: A cross-sectional, online survey.","authors":"Ajinkya Sureshrao Ghogare,&nbsp;Pradeep Shriram Patil,&nbsp;Mamidipalli Sai Spoorthy,&nbsp;Swapnil Arunrao Aloney,&nbsp;Ashish Wasudeorao Bele,&nbsp;Ranjit S Ambad","doi":"10.25259/NMJI-35-3-147","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-147","url":null,"abstract":"<p><p>Background The Covid-19 pandemic caused a rapidly evolving and confused situation. Health sciences students (HSSs) are not immune to depression, anxiety and stress during such a pandemic. We aimed to assess the relation between depression, anxiety, stress and resilience among undergraduate HSSs during the Covid-19 lockdown. Methods We conducted a cross-sectional, online survey at a rural tertiary healthcare centre in Maharashtra. Data were recorded from study participants on sociodemographic details using the 21-item Depression, Anxiety and Stress Scale (DASS-21) and the Brief Resilience Scale (BRS). Data were analysed using SPSS software version 15.0. Results A total of 381 students participated in the online survey. The prevalence of depression, anxiety and stress were 7.6%, 6.3% and 1.0%, respectively. There was a positive correlation between all three sub-scales of DASS-21. On BRS, 5 (1.3%) participants had high resilience, 216 (56.7%) had normal resilience and 160 (42.0%) had low resilience. Those respondents who had high resilience had lower rates of depression, anxiety and stress on DASS-21 sub-scales. Conclusion A proportion of HSSs had anxiety, depression and stress during the Covid-19 outbreak and lockdown. Respondents with high resilience had less frequent depression, anxiety and stress. In the long run, strengthening resilience of HSSs may be useful.</p>","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"147-152"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40559028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A family with nutmeg poisoning due to a home-made 'Covid treatment syrup'.","authors":"Kushan Medagoda","doi":"10.25259/NMJI-35-3-187","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-187","url":null,"abstract":"","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"187"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40549144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective-structured clinical examination in cardiovascular system for the assessment of internal medicine postgraduates amidst the Covid-19 pandemic.","authors":"Atit A Gawalkar,&nbsp;Ganesh Kasinadhuni,&nbsp;H Mohan Kumar,&nbsp;Sarabmeet S Lehl,&nbsp;Savita Kumari,&nbsp;Rajesh Vijayvergiya","doi":"10.25259/NMJI-35-3-172","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-172","url":null,"abstract":"Background The Covid-19 pandemic has posed a challenge to organizing a safe clinical assessment for postgraduate degree candidates completing the residency programmes in various specialties. Although minimizing the risk of Covid-19 transmission is a priority, fulfilling the objectives of the assessment is equally important. Methods We conducted this study in the Department of Internal Medicine at our institute. Instead of physically examining patients, case scenarios that included history, clinical and investigational data of the cardiovascular system (CVS) were presented to the candidates. Performance was scored by both the conventional and the CVS objective-structured clinical examination (CVS-OSCE) method and compared. Results Clinical assessment examination of 27 candidates for the degree of Doctor of Medicine showed that the median cumulative score gained in narrating and analysing various differential diagnoses was lower compared to the mean cumulative score gained in arriving at a single correct diagnosis (50% [interquartile range-IQR 39%-64%] v. 79% [IQR 64%-100%], p<0.01). Most of the candidates agreed that case scenarios were good alternatives to the conventional physical examination amidst the pandemic. Conclusion CVS-OSCE-based assessment using structured case scenarios is a feasible and effective alternative for clinical skill assessment in high-stake examinations.","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"172-176"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40457979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swirling of retinoscopy.","authors":"Amber Amar Bhayana,&nbsp;Priyanka Prasad,&nbsp;Sudarshan Khokhar","doi":"10.25259/NMJI-35-3-186","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-186","url":null,"abstract":"","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"186"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40458377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of symptom characteristics and comorbid conditions with viral RNA positivity of Covid-19 patients in Kasaragod district in Kerala, India: A retrospective cohort study.","authors":"Raman Swathy Vaman,&nbsp;Mathew J Valamparampil,&nbsp;Basil Varghese,&nbsp;Elezebeth Mathews,&nbsp;M Kunhiraman,&nbsp;Rajesh Ramachandran","doi":"10.25259/NMJI-35-3-138","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-138","url":null,"abstract":"<p><p>Background Symptoms of Covid-19 are known to be non-specific ranging from asymptomatic cases to severe illness affecting multiple organ systems. The duration of viral RNA positivity and transmission varies in individuals. We describe the association between symptom characteristics and comorbid conditions with viral RNA positivity of SARSCoV-2 affected individuals. Methods We conducted a record-based retrospective cohort study of 179 patients found to be positive for Covid-19 in Kasaragod district in Kerala. We included details of all patients found positive during the initial phases of the pandemic and recorded details regarding symptoms, duration of viral RNA positivity and the occurrence of transmission. The data were analysed using SPSS. Results Any symptom was present in 68%. Fever (43%) was the most common symptom while 50% had at least one respiratory symptom. Increased duration of viral RNA positivity was found to be associated with presence of comorbid conditions. The majority of individuals who transmitted disease (75%) had some symptom, predominantly a respiratory symptom. Conclusion Respiratory symptoms are seen in half of the patients and viral RNA positivity was for a longer duration in patients with comorbid conditions.</p>","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":"35 3","pages":"138-141"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614525/pdf/EMS175053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9466152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covid-19-associated rhino-orbito-cerebral mucormycosis (CAROM) in Delhi: Demographics and risk factors in a single-centre consecutive cohort of 200 inpatients.","authors":"Anup Singh,&nbsp;Kapil Sikka,&nbsp;Gaurav Goel,&nbsp;Anupam Kanodia,&nbsp;Aswin Chandran,&nbsp;Abhilash Konkimalla,&nbsp;Smriti Panda,&nbsp;Rohit K Garg,&nbsp;Immaculata Xess,&nbsp;Nikhil Tandon,&nbsp;Alok Thakar","doi":"10.25259/NMJI-35-3-132","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-132","url":null,"abstract":"<p><p>Background There was a dramatic rise in the incidence of rhino-orbito-cerebral mucormycosis associated with the 2021 Covid-19 wave in India. We aim to document the demographic characteristics and risk factors of a consecutive cohort of inpatients with Covid-19-associated rhino-orbito-cerebral mucormycosis (CAROM) during the surge of April-June 2021. Methods We included all patients of CAROM treated at our tertiary referral facility from 1 April to 14 June 2021. We prospectively gathered details with regard to Covid-19 illness and treatment, CAROM presentation, comorbid conditions and risk factors. Results Our prospective cohort consisted of 200 consecutive patients, of which 146 (73%) patients tested positive on the Covid-19 RT-PCR test at presentation. CAROM occurred concurrent with the Covid-19 infection in 86%, and delayed CAROM after seeming recovery from Covid-19 was seen in 14%. Covid-19 was classified as mild, moderate and severe in 54%, 33% and 13%. The surge of CAROM followed the population peak of Covid-19 infections by about 3 weeks. Advanced disease at presentation was frequent with ocular involvement in 56.6% (111/196) and central nervous system involvement in 20% (40/199). One or more comorbid conditions were identified in 191/200 (95.5%) patients. The dominant associations were with diabetes (189/200; 94.5%) and uncontrolled hyper-glycaemia (122/133; 91.7%), recent steroid use (114/ 200; 57%), which was often considered as inappropriate in dosage or duration, lymphopenia (142/176; 80.7%), and increased ferritin levels (140/160; 87.5%). No evidence supported the role of previous oxygen therapy or previous nasal swab testing as risk factors for CAROM. Conclusion The inpatient volumes of CAROM were noted to parallel the Covid-19 incidence curve by about 3 weeks. Covid-19 infection may directly predispose to CAROM by way of lymphopenia and increased ferritin levels. Uncontrolled hyperglycaemia is identified as a near-invariable association. Recent steroid use is noted as very frequent and was often received in excess of treatment advisories.</p>","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"132-137"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40549149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer care continuum at a tertiary care centre in India during the Covid-19 pandemic and nationwide lockdown: Healthcare delivery through telemedicine.","authors":"Anant Gokarn,&nbsp;Amit Joshi,&nbsp;Tabassum Wadasadawala,&nbsp;Seema Gulia,&nbsp;Swapnil Wakle,&nbsp;Anuj Singh,&nbsp;Apoorva Tiloda,&nbsp;Abhishek Singh,&nbsp;Debanjan Chakraborty,&nbsp;Vignesh Subramani,&nbsp;Pooja Bajaj,&nbsp;Sravan Kumar Chintala,&nbsp;Bhagyashree Pathak,&nbsp;Vijai Simha,&nbsp;Sahil Sood,&nbsp;Babusha Kalra,&nbsp;Manasi Bhandari,&nbsp;Sale Avonu,&nbsp;Prahalad Elamarthy,&nbsp;Shasanka Das,&nbsp;Rabi Shankar Dash,&nbsp;Jayshree Jansari,&nbsp;Nishtha Sehra,&nbsp;Tejas Vispute,&nbsp;Jagruti Thakur,&nbsp;Laxman Gawade,&nbsp;Chandana Vemuri,&nbsp;Siddhartha Nekkanti,&nbsp;Yogesh Bansod,&nbsp;Lovedeep Chauhan,&nbsp;Renish Chhatrala,&nbsp;B Gurukeerthi,&nbsp;Ravi Shankar,&nbsp;R Narayanan,&nbsp;V Preeti,&nbsp;Preethi Shetty,&nbsp;Rajesh Dikshit,&nbsp;Navin Khattry,&nbsp;Sudeep Gupta,&nbsp;Nishu Goel,&nbsp;Rajendra A Badwe","doi":"10.25259/NMJI-35-3-142","DOIUrl":"https://doi.org/10.25259/NMJI-35-3-142","url":null,"abstract":"<p><p>Background The Covid-19 pandemic and subsequent lockdown in India caused disruptions in cancer treatment due to the restriction on movement of patients. We aimed to maintain continuity in cancer treatment during the lockdown through teleconsultations. We tried to reach out to our patients using telephonic consultations by establishing a Teleconsult Centre facility run by a team of doctors and patient navigators. Methods We telephonically contacted all patients who had outpatient appointments from 23 March to 30 April 2020 at our centre through the Teleconsult Centre to understand their current circumstances, feasibility of follow-up, local resources and offered best possible alternatives to continue cancer treatment, if required. Results Of the 2686 patients scheduled for follow-up during this period, we could contact 1783 patients in 9 working days. Through teleconsultations, we could defer follow-ups of 1034 patients (57.99%, 95% confidence interval [CI] 55.6%-60.3%), thus reducing the need for patients to travel to the hospital. Change in systemic therapy was made in 75 patients (4.2%, 95% CI 3.3%-5.2%) as per the requirements and available resources. Symptoms suggestive of disease progression were picked up in 12 patients (0.67%, 95% CI 0.35%-1.17%), who were advised to meet local physicians. Conclusion Our study suggests that the majority of patients on follow-up can be managed with teleconsultation in times of crisis. Teleconsultation has the potential of being one of the standard methods of patient follow-up even during periods of normalcy.</p>","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"142-146"},"PeriodicalIF":0.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40547594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic determinants of high tobacco use in Gond tribe of central India.","authors":"Surendra Kumar,&nbsp;Ravendra Kumar Sharma,&nbsp;Visheshwar Soan,&nbsp;Maya Pandey,&nbsp;Aftab Ahemad Khan,&nbsp;Shardha Tiwari,&nbsp;Manoj Sharma","doi":"10.25259/NMJI_351_20","DOIUrl":"https://doi.org/10.25259/NMJI_351_20","url":null,"abstract":"<p><p>Background The prevalence of tobacco use is high in rural India, but limited information on tobacco use among the tribal population is available. We assessed the prevalence of tobacco use and type of tobacco use in the Gond tribal population. Methods We did a cross-sectional survey among the Gond tribal population residing in the Kundam block of Jabalpur district in Madhya Pradesh state in India. The study was carried out among persons aged 6 years and above during February-May 2017. Pre-tested interview schedules were used by trained field investigators to collect information on tobacco use. Results A total of 3351 individuals were included in this study, of which 58% were using some form of tobacco. The prevalence of tobacco use was higher among men compared to women, and it increased significantly from age 6 to 25 in both men and women. Tobacco use was significantly associated with age, gender and educational status of the respondents. Conclusion The study highlights a high tobacco use in the Gond tribe population. The high prevalence of tobacco use in younger ages is a matter of serious concern. The study establishes a need for information, education and communication and behavioural change communication activities; health camps focusing on the harmful effects of tobacco use and tobacco control campaign among tribal communities, tribal schools and ashrams.</p>","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"74-77"},"PeriodicalIF":0.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40549143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enteric Fever Still haunts us with New Challenges.","authors":"Aashna Gandhi,&nbsp;Geethu Joe,&nbsp;Rajeev Soman","doi":"10.25259/NMJI_725_22","DOIUrl":"https://doi.org/10.25259/NMJI_725_22","url":null,"abstract":"","PeriodicalId":49782,"journal":{"name":"National Medical Journal of India","volume":" ","pages":"65-67"},"PeriodicalIF":0.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40570003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}