Current medicine research and practice最新文献

{"title":"Is digital innovation killing empathy in health care? The realities of patient care in a tech-driven world","authors":"GopalSingh Charan, Amanpreet Kaur, Kiranpreet Kaur","doi":"10.4103/cmrp.cmrp_72_23","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_72_23","url":null,"abstract":"The health care industry has experienced a digital transformation that has enhanced efficiency, accuracy and access to information. As digital innovation continues to revolutionise health care, there is growing concern about its impact on empathy–the ability to understand and share the feelings of others. The rise of telemedicine, electronic health records (EHRs) and other digital tools has changed the way health care providers interact with patients, leading some to worry that technology is eroding the human touch that has long been a hallmark of good medical care. THE RISE OF DIGITAL INNOVATION IN HEALTH CARE Digital innovation has reshaped health care, impacting diagnosis, treatment and patient communication. Telemedicine enables remote consultations, decreasing the need for in-person visits and allowing care delivery to remote or underserved areas.[1] EHRs have also transformed health care by allowing health care providers to store and access patient data electronically. EHRs make it easier for providers to track patients’ medical history, test results and other critical information, which can improve the quality of care.[2] Digital tools such as mobile health apps and wearables enable real-time patient–provider communication and health tracking. These tools aid in chronic condition management and supply valuable data for informed medical decisions. THE IMPACT OF DIGITAL INNOVATION ON EMPATHY IN HEALTH CARE While digital innovation has many benefits, some worry that it is eroding empathy in health care. Empathy is essential to good medical care because it helps providers understand patients’ emotions, concerns and needs, which can inform treatment decisions and improve patient outcomes. A concern with the growth of telemedicine and digital tools is the reduction in face-to-face interactions between patients and providers. The lack of in-person visits may limit opportunities to observe non-verbal cues and build rapport, potentially hindering empathy and personalised care. Another concern is that the use of EHRs may be reducing the amount of time providers spend engaging with patients. Providers may spend more time documenting patient information and less time interacting with patients, which can make it harder to build relationships and establish trust.[3] STRATEGIES TO ADDRESS THE CHALLENGES OF TECHNOLOGY IN PATIENT CARE Patients seek empathy and understanding from health care providers as the absence of it could cause negative emotions such as frustration, anxiety and distrust. However, a lack of empathy can lead to distrust. Patients want collaborative care that acknowledges their specific needs and preferences, which entails listening to their concerns. Hospital executive leadership must devise strategies to tackle technology-related challenges in patient care. Preventing empathy erosion requires prioritising and training health care providers in communication, active listening and empathy, which enhances patient outcomes and satisfaction.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135446837","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":"Pre-operative evaluation in geriatric patients – Demography does matter","authors":"H. Gupta","doi":"10.4103/cmrp.cmrp_101_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_101_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"22 1","pages":"45 - 46"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84323914","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":"Knowledge of health-care professionals on tobacco cessation and its related activities","authors":"Neetu Kataria, Sandhya Gupta","doi":"10.4103/cmrp.cmrp_99_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_99_22","url":null,"abstract":"Background: The tobacco epidemic is one of the biggest public health threats the world has ever faced. There are more than 4000 chemicals in tobacco smoke, of which at least 300 are known to be harmful. A 2015 survey in Italy revealed that 58% of cardiologists correctly indicated smoking as an addiction and 45% regularly advised their patients to stop smoking. Aims: The aim is to assess the knowledge of health care professionals (HCPs) related to tobacco cessation and its related activities. Materials and Methods: A descriptive, cross-sectional, pilot survey on HCPs-30 doctors and 30 nurses was chosen by convenient sampling at a selected tertiary care hospital in New Delhi. Tool: A semi-structured questionnaire contains items to assess knowledge of HCPs regarding tobacco cessation and its activities. Results: 96.3% of doctors and 76% of nurses were 'asked' their patients about their history of tobacco use, respectively. 86.7% of doctors and 70.1% of nurses 'advice' patients to stop tobacco use. 63.3% of doctors and 54.1% of nurses were interested in participating in tobacco cessation training. Conclusion: Most of the HCPs had given brief interventions by 5 'A's method. More tobacco cessation training would be suggested by health-care workers.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"441 1","pages":"18 - 25"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82915710","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":"Revisiting efavirenz in the era of dolutegravir: Low-dose efavirenz, a viable alternative capable of holding its own against dolutegravir-based regimens","authors":"Anirudh Anilkumar, Sumit Arora, KuldeepK Ashta, Nishant Raman","doi":"10.4103/cmrp.cmrp_98_23","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_98_23","url":null,"abstract":"Background: First-line dual NRTI + NNRTI-based ART has shown good virological effectiveness; however, toxicity is common and is often the most common reason for modification of first-line ART. Aims: The purpose of this study is to revisit low-dose efavirenz (EFV) in the era of dolutegravir (DTG) by investigating anti-retroviral therapy (ART) switch strategies for outcomes of virological effectiveness and safety in virologically suppressed Indian persons living with HIV (PLH) on first-line dual nucleoside reverse transcriptase inhibitors (NRTI) + non-NRTI (NNRTI)-based ART. Methods: A phase-IV comparative study of consecutive cases who switched their first-line NNRTI-based ART to either EFV-400 or DTG with a dual NRTI backbone between October 2020 to December 2021 and underwent at least 48 weeks of follow-up. The study is a non-randomised trial, wherein ART regimens were based on physician choice, patient preference and drug availability. Results: A total of 102 [DTG arm: 52; EFV-400 arm: 50; intention-to-treat (ITT) population] participants met the inclusion criteria. At 48-week follow-up, virological failure was not observed in either arm. Virological suppression to < 200 cp/mL was attained in 97.9% (n = 48/49; 95% confidence interval [CI]: 89.1–99.9) and 95.9% (n = 47/49; 95% CI: 86.02–99.5) of patients, respectively, in the DTG and-EFV-400 arm (ITT-populations). There was no significant difference in mean change from baseline in body weight and body mass index between DTG and-EFV-400 arms. The proportion of patients who gained ≥ 10% of their baseline body weight at 24 weeks of exposure to DTG was 16% (n = 8, 95% CI: 5.8 to 26.2) and that to EFV-400 was 10% (n = 5, 95% CI: 1.7 to 18.3) with a difference in proportions: 6.0% (95% CI: −7.1–19.1)]. There was a significant decrease at 24 weeks in mean fasting levels of lipid fractions in the DTG arm as compared to EFV-400 [total cholesterol: − 24.3 mg/dL, 95% CI: −35.2 to − 13.3 vs. −6.9 mg/dL, 95% CI: −17.9–4.1 (P = 0.029) and triglycerides:−35.9 mg/dL, 95% CI: −60.9 to − 10.9 vs. 8.6 mg/dL, 95% CI: −16.6 to 33.8 (P = 0.014)]. Adverse events (AEs) of any grade including laboratory derangements to DTG were experienced by 6% (n = 3, 95% CI: −0.6 to 12.6) and that to EFV-400 by 8% (n = 4, 95% CI: 0.5 to 15.5) with a difference in proportions: 2.0% (95% CI: −7.9 to 11.9). Grades 3–4-AE occurred in two patients, both in the EFV-400 arm. Central nervous system AEs were not observed in the DTG arm and occurred in two patients in the EFV-400 arm. Two patients in the EFV-400 arm discontinued the regimen due to AEs. Conclusion: Both DTG and EFV-400-based first-line ART show good virological effectiveness and safety profiles in patients who are virologically suppressed on dual NRTI + NNRTI-based first-line ART.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"294 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135445597","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 risk of abuse and mental health status of elderly residing in urban communities of Delhi","authors":"Sumity Arora, Raminder Kalra","doi":"10.4103/cmrp.cmrp_114_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_114_22","url":null,"abstract":"Background and Objectives: Elderly is a vital part of the population of any country who owe respect and attention equally to any other section of the population. The present study was aimed at assessing the risk of abuse amongst the elderly, mental health status of elderly and correlation of abuse with their mental health of the elderly residing in urban communities of Delhi. Materials and Methods: This study was cross-sectional and descriptive conducted on 270 elderly chosen by cluster sampling method residing in the urban community of South Delhi, India. Sociodemographic data, elder abuse and their mental health were assessed by sociodemographic tool, Hwalek-Sengstock Elder Abuse Screening Test and Self Reporting Questionnaire (SRQ-20), respectively. Results: Online Social Science Statistics package was used for analysis of the study. In the present study, majority of the participants were male and were in the age of 61–70 years. Approximately 50% of elderly were uneducated and not working. The majority (63%) of the elderly reported a mild risk of abuse. The majority of the participants reported altered mental health, i.e., SRQ >7. In the study findings, elder abuse and mental health were significantly associated (at P < 0.05) with each other. Conclusion: The study showed that elder abuse and mental well-being of elderly are related to each other and it requires appropriate involvement of concerned authority to protect elderly living in the community of Delhi, India.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"7 1","pages":"10 - 14"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82878682","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":"Intraperitoneal onlay mesh versus laparoscopy-assisted ventral hernia patch mesh repair in small primary ventral hernias: A randomised control trial","authors":"Harish Kanuri, A. Dey, T. Mittal, S. Tripathi:, V. Malik","doi":"10.4103/cmrp.cmrp_138_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_138_22","url":null,"abstract":"Aims: The aim of this study is to compare and evaluate short-term outcomes of laparoscopy-assisted composite patch mesh repair versus laparoscopic intraperitoneal onlay mesh in small primary midline ventral hernias. Materials and Methods: Eighty consecutive patients with small (<2 cm) midline ventral hernia admitted to the Department of General and Laparoscopic surgery at Sir Ganga Ram Hospital, New Delhi, from January 2017 to May 2019 were included in the study and randomised into two groups. Group A included patients who underwent laparoscopic intraperitoneal onlay mesh repair with the classical barrier flat mesh and Group B patients underwent laparoscopy-assisted ventral hernia patch-mesh repair. Parameters assessed at the follow-up were early post-operative pain by Visual Analogue Scale score, wound complications, early recurrence and hospital stay. Results: Early post-operative pain was more in the laparoscopic intraperitoneal onlay mesh group and the difference was statistically significant. Usage of additional analgesia in the post-operative period was required only in the laparoscopic intraperitoneal onlay mesh group. There was a statistically significant difference between the two groups in terms of hospital stay. Conclusion: For primary midline ventral hernia, with defect size <2 cm, laparoscopy-assisted composite patch mesh repair is feasible and safe. It causes less pain and necessitates less usage of additional analgesia enabling patients to be discharged earlier.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"17 1","pages":"4 - 9"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88452545","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":"Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting","authors":"Panneerselvam Periasamy, Suganthi Vajiravelu, S. Gunasekaran","doi":"10.4103/cmrp.cmrp_55_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_55_22","url":null,"abstract":"Background: Understanding medical students' mental health using subjective well-being indicators is important because it will allow for the creation of positive psychology-based intervention techniques as well as the implementation of main and secondary psychiatric disorder prevention procedures for medical students. These indicators may help to improve the overall quality of health care provided by these future professionals to the general public. Aims: The aim of the present study was to assess the levels of stress and subjective well being as well as factors related to it and their link to the academic performance amongst medical students of a tertiary care setting. Materials and Methods: This is a 3-month cross-sectional survey that took place amongst medical students at a tertiary care medical college in Salem, India, between January and March 2022. Students from all academic years, from first year to internship, were included in this study. The study included all students who were willing to participate and gave their informed consent. Results: Of the total 492 respondents, 288 (58.5%) were females and 204 (41.5%) were males. 29.7% of the study participants belonged to the first year of the MBBS course. 43.9% of the study participants possess a very good academic performance and majority (86.6%) of the students have regular attendance towards classes. Conclusion: Taken together, the findings of studies like these could inform preventive interventions aimed at reducing medical students' distress and promoting future doctors' well-being.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"57 1","pages":"15 - 17"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85040151","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":"Telemedicine: Zero Contagion risk and enabler of healthcare fire sales","authors":"Neha Ghildiyal, M. Bangari","doi":"10.4103/cmrp.cmrp_57_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_57_22","url":null,"abstract":"India has made remarkable progress in ease of doing business, competitiveness and technological innovation in the past few years. During the COVID-19 pandemic, telemedicine entered the healthcare sector as a boon. Telehealth witnessed accelerated adoption during the COVID-19 pandemic, finding its niche amongst the emerging digitally enabled India. Medical centres are responding to the needy through the use of digital tools and technology, such as telemedicine and virtual care, along with various other virtual means. This research paper discusses the application of the Internet and other related technologies in the health sector for improving access to and efficiency, efficacy and quality of clinical and corporate processes used by healthcare organisations, physicians, patients and consumers to improve the health status of patients. The use of telemedicine during the pandemic has experienced rapid growth. This study essentially focuses on the importance of telemedicine during such trying times. The literature review was performed to study the importance, advantages and disadvantages of telemedicine in India during the pandemic. In addition, research articles, and databases, including Google Scholar, PubMed and Ovid MEDLINE, were searched to study the changes that are rapidly entering the healthcare sector and the efficacy of the concept of telemedicine for patients.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"47 3 1","pages":"26 - 31"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78255327","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":"Invasive micropapillary carcinoma of ampulla of Vater in a young female with negative lymph nodes: A case report and review of literature","authors":"KhadigaMohamed Ali, ManalM S. Elghareeb, GehadAhmad Saleh, AmalA F. Halim","doi":"10.4103/cmrp.cmrp_106_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_106_22","url":null,"abstract":"Invasive micropapillary carcinoma (IMPC) is an extremely rare and aggressive subtype of adenocarcinoma that was first described in breast cancer. It is characterised by an inside-out growth pattern with frequent lymphatic spread. Only few cases are described in the rare ampullo-pancreatobiliary location. In this case report, the diagnosis was unexpected given the patient’s age and gender, as well as the negative nodal status. Despite the reported aggressive behaviour of this tumour, no optimal treatment strategy for IMPC in the ampulla of Vater has been established. In addition, this variant is not included in the recent WHO of the digestive system.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"67 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135445277","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":"Emerging and newer diseases in India: A perspective","authors":"A. Kakar, K. Sam, S. Kakar","doi":"10.4103/cmrp.cmrp_3_23","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_3_23","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"235 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76820869","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}