MGM Journal of Medical Sciences最新文献

{"title":"An evolutionary explanation for increased cesarean section rates","authors":"Sunil Sharma, Aakriti Anurag","doi":"10.4103/mgmj.mgmj_168_22","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_168_22","url":null,"abstract":"","PeriodicalId":52587,"journal":{"name":"MGM 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":"41470385","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":"Role of machine learning techniques in classification of peripheral pulse morphology","authors":"N. Patil, Sushma N Bhat, Janisha Christopher, Rameshwari Abhane, Uttam Rajaram Bagal, Gajanan D. Nagare","doi":"10.4103/mgmj.mgmj_13_23","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_13_23","url":null,"abstract":"Recording of peripheral pulse serves as a very important and essential non-invasive tool used widely by doctors for the diagnosis of various diseases. The morphology of pulse is seen to vary as a function of time in a given individual and also from individual to individual. There are many variations in morphological patterns of peripheral pulse in different disease conditions, which lead to difficulty in accurate diagnosis. The peripheral pulse waveforms are extracted from radial arteries as time series data using a peripheral pulse analyzer which is designed on the principle of impedance plethysmography. It was first introduced by Nyober in the mid-nineteen hundreds and ameliorated further by Kubicek. It involves the recording of the instantaneous blood volume by the measurement of electrical impedance as a function of time. Therefore, the study of peripheral pulse morphology has gained much attention in the past few years among researchers. Physiological variability is one of the recent investigations added during the last two decades for the objective assessment of autonomic function and the assessment of prognosis in severe sicknesses namely myocardial infarction, diabetic neuropathy, etc. In addition to heart rate variability studied worldwide, few researchers have studied blood pressure variability and peripheral blood flow variability. In this computer era, artificial intelligence and machine learning techniques have become more important day-by-day, and different types of algorithms were used for the identification of hidden patterns from plethysmographic observations on the radial pulse such as support vector machine as well as crisp and fuzzy clustering. Eight patterns were classified with a yield of 80%–90% and helped with the diagnosis of disorders such as myocardial infarction, pulmonary tuberculosis, coronary artery disorders, cirrhosis of the liver, and bronchial asthma. This paper briefly describes the use of machine learning techniques for the classification of peripheral pulse morphologies.","PeriodicalId":52587,"journal":{"name":"MGM 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":"47781987","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":"Dyslipidemia as a risk factor for acute myocardial infarction in postmenopausal women: An observational study","authors":"Pradipta Som, Bikash C Seth, Malay Acharyya","doi":"10.4103/mgmj.mgmj_230_22","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_230_22","url":null,"abstract":"Objective: This study has evaluated risk factors, especially dyslipidemia, for an acute myocardial infarction (AMI) in postmenopausal women. Materials and Methods: This was a hospital-based, observational, single-center study among 100 postmenopausal women admitted to the medicine ward with AMI. They were categorized based on lipid profile groups, viz., dyslipidemic group and non-dyslipidemic group. All clinical parameters were studied between the groups. Results: Among anthropometric profiles, in the comparison of mean height (cm), weight (kg), body mass index (BMI) (kg/m2), and waist circumference (WC) (cm) for the dyslipidemic group and non-dyslipidemic group, only WC was statistically significant (P < 0.001). Most patients were hospitalized between 6 and 12 h after the onset of symptoms. At the time of hospitalization, most patients from both groups were observed to have diabetes and hypertension with poor control of postprandial blood sugar, glycated hemoglobin, and diastolic blood pressure (DBP) (P < 0.05). The dyslipidemic group’s mean C-reactive protein was higher (P < 0.05). The comparison of mean total cholesterol, triglyceride (TG), low density lipoprotein-cholesterol in mg/dL, and TG: high density lipoprotein was significantly increased (P < 0.001), while high density lipoprotein-cholesterol (mg/dL) was significantly decreased (P < 0.001) in the dyslipidemic group. ST-segment elevation myocardial infarction is standard in both groups. The maximum patient has regional wall motion abnormality in echocardiography after day 3 of admission. Among the dyslipidemic group, ejection fraction was on the lower side, and the predominant complication was in the left ventricular failure (LVF) (P < 0.05). Conclusion: WC has a positive association with patients with AMI who have dyslipidemia and can be used as an indicator of the risk of AMI when BMI is normal. WC is a surrogate marker of abdominal fat mass (subcutaneous and intra-abdominal); increased WC is a significant component marker of metabolic syndrome and insulin resistance related to cardiovascular mortality. There was poor glycemic control and blood pressure (mainly DBP) among the dyslipidemic patients. Hypertriglyceridemia is the most common lipid abnormality, followed by hypercholesterolemia among the dyslipidemic group. LVF is the most common complication in dyslipidemic patients.","PeriodicalId":52587,"journal":{"name":"MGM 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":"49045116","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":"Surveillance of hand hygiene practices in hospitals, its evaluation, and audit","authors":"Gurjeet Singh, Raksha Singh, RangaReddy Burri","doi":"10.4103/mgmj.mgmj_178_23","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_178_23","url":null,"abstract":"Background: Healthcare-associated infections (HAIs) continue to pose a significant challenge within most intensive care units. The most straightforward and impactful approach to mitigate these HAIs remains proper hand hygiene. Consequently, evaluating documented hand hygiene routines and conducting direct observations are vital in identifying deficiencies. Thus, this enables the formulation of focused approaches to reduce HAIs. Study objectives: (a) To evaluate the hand hygiene practices among healthcare workers and (b) to analyze the factors contributing to non-compliance. Materials and Methods: The research was conducted at the Mayo Institute of Medical Sciences, Intensive Care Unit, Barabanki, Uttar Pradesh, India. This endeavor adopted an observational approach, involving 50 healthcare workers (HCWs) for direct observation and an additional 50 for the evaluation of documented hand hygiene practices. Data collection relied upon the utilization of questionnaires and observation instruments. Results: The investigation brought to light a contrast between the perspectives of healthcare workers and their actual hand hygiene practices. The collective adherence rate stood at 67.08% (with the observation study encompassing 75 HCWs and 111 instances where hand hygiene should have been carried out, out of which only 76 were performed). Notably, physiotherapists exhibited a notably higher compliance rate at 78%, whereas nurses and residents demonstrated a compliance rate of 68%. In contrast, technicians and unit helpers displayed a lower adherence rate of 60%. Regarding reported hand hygiene compliance among HCWs, the figures exceeded 90% (derived from a questionnaire administered to 50 HCWs, some of whom may or may not have been part of the observation study). Nurses reported an impressive 98% compliance, technicians reported 81%, and other personnel reported rates ranging between 90% and 95%. Conclusion: The researcher undertook two distinct investigations involving direct observation and the other based on reported data. The findings from the observational study indicated a collective hand hygiene compliance rate of 67.08%, whereas the reported study yielded a compliance rate exceeding 90% among HCWs.","PeriodicalId":52587,"journal":{"name":"MGM 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":"136368092","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 retrospective study on maternal and fetal outcomes of pregnancy with COVID-19","authors":"AnuyaA Pawde, MayuriV More, AishwaryaO Mainani, ShrutiV Shrivastava, Sudharani Gandi, Sriram Gopal","doi":"10.4103/mgmj.mgmj_177_23","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_177_23","url":null,"abstract":"Background: On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global health emergency. At that time, it was unclear how COVID-19 affected pregnant individuals and whether its symptoms presented differently than nonpregnant women. Objective: To investigate the effects of COVID-19 on both the pregnant mother and the developing fetus. Materials and Methods: This retrospective analysis concentrated on 58 pregnant individuals diagnosed with SARS-CoV-2 infection between March 1, 2020, and February 28, 2022, at a Tertiary Care Center in Navi Mumbai, India. This study aimed to investigate the effects of COVID-19 infection on maternal and fetal well-being during pregnancy. Results: In the study’s findings, it was observed that among the participants, 48.3% were primigravida (experiencing their first pregnancy), whereas 51.7% were multigravida (having been pregnant previously). Of the participants, 44% underwent lower segment cesarean section, whereas the remaining 56% had vaginal deliveries. The primary indications for performing cesarean sections were oligohydramnios and fetal distress. Approximately 41.3% of the newborns required admission to the Neonatal Intensive Care Unit. The neonatal mortality rate was recorded at 5.1%, and none of the newborns tested positive for COVID-19. Conclusion: In summary, while most patients were admitted without symptoms (89.7%) or mild symptoms, it became evident that COVID-19 was a virulent virus capable of causing rapid and unexpected deterioration in the mothers’ health, ultimately impacting fetal well-being. Notably, this study only observed fatalities during the second wave of the pandemic.","PeriodicalId":52587,"journal":{"name":"MGM 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":"136368303","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":"An overview of electives in community medicine: A giant leap ahead","authors":"H. Rajasekar, K. Annadurai, Aruna Kasi","doi":"10.4103/mgmj.mgmj_214_22","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_214_22","url":null,"abstract":"","PeriodicalId":52587,"journal":{"name":"MGM 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":"45161849","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":"Awareness, willingness, and challenges of the informal sector toward state National Health Insurance Services in Benin City, Nigeria","authors":"N. Osunde, O. Olorunfemi, R. Oduyemi","doi":"10.4103/mgmj.mgmj_191_22","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_191_22","url":null,"abstract":"Background: As access to vital health services expands and universal health coverage is attained, health insurance is projected to serve as a critical risk protection for families and small enterprises. Aim: To assess the informal sector’s awareness, willingness, and problems in enrolling in the state national health insurance program. Materials and Methods: This cross-sectional descriptive study was done in Benin City, Nigeria, in the unorganized sector. A self-structured questionnaire was created, distributed, and retrieved for this study, which was conducted among 155 artisans chosen through a stratified random sample procedure. To evaluate the data, Statistical Package for the Social Sciences, SPSS version 22 was used. Results: In total, 138 people (89.0%) are aware of the National Health Insurance Scheme (NHIS), while only 93 people (60.0%) know that Edo state has a state-owned Health Insurance Scheme (SHIS). Only 17 people, or 11.0%, are engaged in the NHIS/SHIS program, whereas 107 people, or 77.5%, have expressed interest. Lack of accessibility to authorized healthcare facilities near house 22 (71.0%) is a significant deterrent to enrollment in the program. Long lines at service points (3.88, 1.093), the time it takes to enroll new members in the program (3.78, 1.101), the time it takes for health maintenance organizations to issue authorization codes (3.62, 1.316), the accessibility of NHIS services outside of registration institutions (3.29, 1.289), and the standard of drugs provided by the SHIS (3.12, 1.358) are all factors that hinder utilization. Sex and place of residence each strongly correlated with readiness to sign up for the program (AOR = 4.234, P = 0.017, 95% CI: 1.293–13.873 and AOR = 5.224, P = 0.007, 95% CI: 1.557–17.530, respectively). Conclusion: The artisans have a low rate of health insurance coverage but are eager to sign up for the program. State policymakers should increase their reach and make enrollment required to attain a higher range.","PeriodicalId":52587,"journal":{"name":"MGM 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":"46067839","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 of Indian citizens regarding lockdown during COVID-19 pandemic in the Indian context","authors":"Shraddha Kulkarni, M. Nannaware, S. Singru, V. Bansod, Col Chawla, K. Kalra","doi":"10.4103/mgmj.mgmj_27_23","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_27_23","url":null,"abstract":"Background: In response to coronavirus disease 2019 (COVID-19), the government of India declared a lockdown on March 24, 2020. This affected the daily life of citizens, influencing the availability of daily needs. There was a diverse opinion among public health experts regarding the implementation of the lockdown. Therefore, this study was planned to assess the perceptions and to study the effects of lockdown and challenges faced by Indian citizens during the lockdown imposed during the COVID-19 pandemic. Materials and Methods: A cross-sectional study was carried out among Indian citizens above 18 years old using the snowball sampling method. Data were collected through Google forms containing a semistructured questionnaire. Results: Of 464 participants, 61.85% of them reported that lockdown is necessary to contain the spread of the coronavirus infection; 50.43% had a negative effect on their job; and felt mental health problems like anxiety, lack of sleep, stress due to increased workload, and the feeling of separated from family. Conclusion: According to the majority of participants, the lockdown was necessary to contain the spread of the pandemic. Participants who faced different problems also found ways to overcome them in a positive way.","PeriodicalId":52587,"journal":{"name":"MGM 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":"47559266","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":"Hemiarthroplasty in geriatric population with neck femur fracture: A retrospective study of 43 cases","authors":"H. Patel, Parag Tank, Harshal Damor, Dhruvesh Katara, Dhaval J Patel","doi":"10.4103/mgmj.mgmj_216_22","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_216_22","url":null,"abstract":"Introduction: Hip fractures in the elderly have represented a major public health concern. Studies have shown that over 90% of the patients having these fractures are people of more than 50 years. These fractures have been classified according to their anatomical location into the neck of femur fracture, intertrochanteric fracture, and subtrochanteric fracture. The neck of femur fractures is associated with high mortality in the elderly compared to young adults. Surgical treatment is an established gold standard, with the option being osteosynthesis and hip replacement. Hemiarthroplasty is one of the gold-standard treatments chosen for the geriatric age group and has yielded universally acceptable results. Materials and Methods: The study evaluates the clinical, radiological, and functional outcomes of hip hemiarthroplasty in elderly with fracture neck of the femur Data of patients above 60 years who were operated on for fracture neck of the femur by bipolar hemiarthroplasty from May 2018 till December 2021were retrieved from the Medical Records Department of SCL Municipal General Hospital, affiliated to NHL Municipal medical college. The patients fitting the inclusion criteria were selected for the study. The sample size was calculated to be 43. Data were collected from the inpatient files, and then patients were asked to complete the questionnaire form during the final follow-up. All the patients were evaluated clinically and radiologically during the follow-up, and the functional outcome was assessed using the Harris Hip Score. Thirty-five patients had a domestic fall as the mode of injury. The lateral decubitus position of all patients was used during the operation that was performed using the Southern Moore approach. Forty patients received cemented femoral stems; the remaining three received press-fit ones. Results: The average age was calculated to be 71.86 years with the male-to-female ratio of 1: 1.15 with an average follow-up of 12.7 months. Eight patients had acetabular erosion at the end of 1 year. There was no femoral stem malalignment or aseptic loosening at the final follow-up. Nine patients had excellent Harris Hip scores, and five had fair scores. The remaining 29 patients had good Harris hip scores. Bipolar hemiarthroplasty has served us well in the study. Forty-one patients were able to get back to their preinjury functional level. Only one patient reported major pain in the hip at the final follow-up. In this study, there was no incidence of dislocation or revision surgeries. Conclusion: The present study modular bipolar hemiarthroplasty provides better pain relief with early mobilization and a good level of return to daily routine activities with minimal complications.","PeriodicalId":52587,"journal":{"name":"MGM 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":"48982768","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":"Achromobacter Spp.: A retrospective review of rare and emerging pathogen","authors":"S. Sinha, Nikhil Raj, Shipra Dobhal, Anupam Das, J. Agarwal","doi":"10.4103/mgmj.mgmj_41_23","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_41_23","url":null,"abstract":"Background: Achromobacter spp. is a rare nosocomial pathogen known to cause many serious infections like bloodstream infection, osteomyelitis, meningitis, urinary tract infections, corneal ulceration, peritonitis, and endocarditis. Materials and Methods: In this study, we retrospectively analyzed all the bacteriological sample records from the bacteriology database from January 2021 to December 2021 to determine the prevalence of Achromobacter spp. Result: Nine patients with Achromobacter xylosoxidans causing bacterial infection were identified, from whom five blood samples, two pus, one respiratory sample, one central venous pressure (CVP), and one cerebrospinal fluid were found positive for Achromobacter spp., among whom one was a 6-year-old patient having the same organism from two different body sites—CVP line and cerebrospinal fluid. Five patients had coinfection with another organism, whereas acute kidney injury was the most common comorbidity. Conclusion: In our single-center experience, approximately 50% of the cases with Achromobacter denitrificans bacteremia suffered from chronic kidney disease and had a history of antibiotic therapy, hospitalization, and the presence of devices. Active research on rising trends of Achromobacter spp. needs to be promoted.","PeriodicalId":52587,"journal":{"name":"MGM 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":"44575814","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}