Journal of postgraduate medicine最新文献

Mediastinal mass in an infant: A rare presentation of extrapulmonary tuberculosis. 婴儿纵隔肿块：罕见的肺外结核表现。

Journal of postgraduate medicine Pub Date : 2025-05-29 DOI: 10.4103/jpgm.jpgm_16_25

R Radhika, M S Tullu, O Shamla, Jje David

{"title":"Mediastinal mass in an infant: A rare presentation of extrapulmonary tuberculosis.","authors":"R Radhika, M S Tullu, O Shamla, Jje David","doi":"10.4103/jpgm.jpgm_16_25","DOIUrl":"https://doi.org/10.4103/jpgm.jpgm_16_25","url":null,"abstract":"Abstract: Tuberculosis as cause of mediastinal mass, is rare in children, and may be seen in immunodeficiencies. Data on the prevalence of mediastinal tuberculosis and on its clinical spectrum and outcome is lacking in children. A 4.5-month-old boy presented with fever and cough since 7 days and increased respiratory activity. He had respiratory distress with hypoxia. Examination revealed decreased breath sounds on the right lung with tracheal shift to the left. Chest radiograph showed homogenous opacity in the right upper zone, with heterogenous opacity in the right middle and lower zones and tracheal shift to left. Computed tomography scan confirmed the presence of mediastinal abscess. Human immunodeficiency virus status of patient's mother and primary immunodeficiency workup of the child were negative. In view of clinical deterioration and non-responsiveness to 10 days of intravenous antibiotics, tuberculosis workup was done. GeneXpert of the abscess aspirate showed Mycobacterium tuberculosis (rifampicin resistant). Patient was labeled as pre-XDR tuberculosis based on the line probe assay. Antitubercular regimen was modified accordingly (linezolid, amikacin, cycloserine, clofazimine, and ethionamide). The child required invasive mechanical ventilation in pediatric intensive care unit (PICU) for 15 days. The patient showed clinical and radiological improvement and was discharged after 6 weeks of inpatient stay. However, the patient was readmitted 16 days later with linezolid-induced lactic acidosis, developed measles, and succumbed to measles complication (pneumonia).","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176291","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}

引用次数: 0

Navigating the labyrinth: Phenotypes of IgG4-related disease. 导航迷宫：igg4相关疾病的表型

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-14 DOI: 10.4103/jpgm.jpgm_757_24

M Shah, K Bajan, R Samant

引用次数: 0

The bitter aftertaste: Chronic pancreatitis and diabetes from codeine cough syrup. 苦的余味：可待因止咳糖浆引起的慢性胰腺炎和糖尿病。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-06 DOI: 10.4103/jpgm.jpgm_531_24

G S Umarji, A S Alicheri, A Chacko, S Bhat

引用次数: 0

Authors, beware of plagiarism in medical writing. 作者们，要小心医学写作中的抄袭。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-14 DOI: 10.4103/jpgm.jpgm_25_25

C A Divecha, M S Tullu

引用次数: 0

Chat GPT, Gemini or Meta AI: A comparison of AI platforms as a tool for answering higher-order questions in microbiology. 聊天GPT， Gemini或Meta AI: AI平台作为回答微生物学高阶问题的工具的比较。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-19 DOI: 10.4103/jpgm.jpgm_775_24

R D Roy, S D Gupta, D Das, P D Chowdhury

{"title":"Chat GPT, Gemini or Meta AI: A comparison of AI platforms as a tool for answering higher-order questions in microbiology.","authors":"R D Roy, S D Gupta, D Das, P D Chowdhury","doi":"10.4103/jpgm.jpgm_775_24","DOIUrl":"10.4103/jpgm.jpgm_775_24","url":null,"abstract":"Introduction: Artificial intelligence (AI) platforms have achieved a noteworthy role in various fields of medical sciences, ranging from medical education to clinical diagnostics and treatment. ChatGPT, Gemini, and Meta AI are some large language models (LLMs) that have gained immense popularity among students for solving questions from different branches of education.Materials and methods: A cross-sectional study was conducted in the Department of Microbiology to assess the performance of ChatGPT, Gemini, and Meta AI in answering higher-order questions from various competencies of the microbiology curriculum (MI 1 to 8), according to CBME guidelines. Sixty higher-order questions were compiled from university question papers of two universities. Their responses were assessed by three faculty members from the department.Results: The mean rank scores of ChatGPT, Gemini, and Meta AI were found to be 102.76, 108.5, and 60.23 by Evaluator 1; 106.03, 88.5, and 76.95 by Evaluator 2; and 104.85, 85.6, and 81.04, respectively, indicating lowest overall mean rank score for Meta AI. ChatGPT had the highest mean score in MI 2,3,5,6,7, and 8 competencies, while Gemini had a higher score for MI 1 and 4 competencies. A qualitative assessment of the three platforms was also performed. ChatGPT provided elaborative responses, some responses from Gemini lacked certain significant points, and Meta AI gave answers in bullet points.Conclusions: Both ChatGPT and Gemini have created vast databases to correctly respond to higher-order queries in medical microbiology in comparison to Meta AI. Our study is the first of its kind to compare these three popular LLM platforms for microbiology.","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"28-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The protective role of cardiovascular health in the associations between cardiometabolic comorbidities and mortality: A national-wide cohort study. 心血管健康在心血管代谢合并症与死亡率之间的关联中的保护作用：一项全国范围的队列研究。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-19 DOI: 10.4103/jpgm.jpgm_776_24

Z Gao, W Qiu, C Xiong, K Zeng, L Li

{"title":"The protective role of cardiovascular health in the associations between cardiometabolic comorbidities and mortality: A national-wide cohort study.","authors":"Z Gao, W Qiu, C Xiong, K Zeng, L Li","doi":"10.4103/jpgm.jpgm_776_24","DOIUrl":"10.4103/jpgm.jpgm_776_24","url":null,"abstract":"Introduction: Whether the protective role of optimal cardiovascular health (CVH) exists among individuals with preexisting cardiometabolic comorbidities and to what extent these impacts on longevity are unknown. This study aims to evaluate the protective effect on mortality in individuals with and without cardiometabolic comorbidities.Materials and methods: This cohort study utilized data from the China Health and Nutrition Survey. CVH was evaluated using the Life's Essential 8 (LE8) metric. Five cardiometabolic comorbidities, namely hypertension, diabetes mellitus (DM), dyslipidemia, chronic kidney disease (CKD), and cardiovascular disease (CVD), were self-reported. The outcome was all-cause mortality.Results: Maintaining intermediate/ideal CVH attenuated the hazardous impact of hypertension (intermediate/ideal CVH: HR: 1.02; 95% CI: 0.71, 1.47; poor CVH: HR: 1.50; 95% CI: 1.16, 1.95), prediabetes (intermediate/ideal CVH: HR: 1.00; 95% CI: 0.64, 1.55; poor CVH: HR: 1.81; 95% CI: 1.30, 2.52), DM (intermediate/ideal CVH: HR: 2.53; 95% CI: 1.65, 3.87; poor CVH: HR: 5.02; 95% CI: 3.74, 6.76), dyslipidemia (intermediate/ideal CVH: HR: 1.13; 95% CI: 0.76, 1.68; poor CVH: HR: 1.29; 95% CI: 0.89, 1.86), and CKD (intermediate/ideal CVH: HR: 1.36; 95% CI: 1.01, 1.84; poor CVH: HR: 1.84; 95% CI: 1.21, 2.79) on longevity ( P for interaction < 0.05). No significant interaction between CVD and CVH was observed in the association with mortality. CVH status significantly interacted with the associations between cardiometabolic comorbidities and the risk of mortality when the number of comorbidities increased up to 3.Conclusions: CVH significantly attenuated the detrimental impacts of cardiometabolic comorbidities on longevity, highlighting the protective role of CVH even in individuals with preexisting cardiometabolic diseases.","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"20-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing and managing iron deficiency anemia in sickle cell disease: Insights from a systematic review and meta-analysis. 评估和管理镰状细胞病缺铁性贫血：来自系统回顾和荟萃分析的见解。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-06 DOI: 10.4103/jpgm.jpgm_590_24

A Jose, A Bodade, M R Madkaikar

{"title":"Assessing and managing iron deficiency anemia in sickle cell disease: Insights from a systematic review and meta-analysis.","authors":"A Jose, A Bodade, M R Madkaikar","doi":"10.4103/jpgm.jpgm_590_24","DOIUrl":"10.4103/jpgm.jpgm_590_24","url":null,"abstract":"Abstract: Sickle cell disease (SCD) is prevalent in Sub-Saharan Africa, the Middle East, and parts of India, where it is often complicated by iron deficiency anemia (IDA). Untreated IDA exacerbates SCD symptoms, reducing quality of life (QOL) and increasing morbidity and mortality. Diagnosis typically depends on ferritin levels, which can be unreliable due to inflammation associated with SCD's altered red cell morphology and chronic hemolysis. This systematic review and meta-analysis explores the interplay between IDA and SCD, focusing on diagnostic criteria for effective management. We conducted a thorough search of PubMed and EMBASE, leading to the selection of 14 studies following PRISMA guidelines. The review protocol was registered in PROSPERO (CRD42023462914). Data extraction, quality assessments, and heterogeneity checks were rigorously performed. Out of 3188 articles, 14 studies met the inclusion criteria, covering 763 SCD cases with 118 instances of IDA. The meta-analysis found an IDA prevalence of 6% (95% CI: 1%-20%) among SCD patients, with high heterogeneity (I 2 = 88.8%). Sensitivity analysis adjusted for publication bias indicated an 8% prevalence (95% CI: 4%-19%) with reduced heterogeneity (I 2 = 19.5%). Subgroup analysis revealed a lower prevalence of IDA in pregnant women (0.01%; 95% CI: 0.00%-0.92%) compared to non-pregnant individuals (7%; 95% CI: 2%-22%). The study highlights significant regional variability in IDA prevalence among SCD patients, emphasizing the importance of early diagnosis and targeted management to improve patient outcomes and QOL.","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

2. Types of data and data collation for efficient processing. 2. 对数据类型和数据进行有效的整理处理。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-06 DOI: 10.4103/jpgm.jpgm_755_24

A Indrayan

{"title":"2. Types of data and data collation for efficient processing.","authors":"A Indrayan","doi":"10.4103/jpgm.jpgm_755_24","DOIUrl":"10.4103/jpgm.jpgm_755_24","url":null,"abstract":"Abstract: Data are the soul of most empirical research. Adequate data collection and their proper collation are essential to arrive at right conclusions. These conclusions are mostly drawn from the statistical analysis of properly collated data. Since the methods of statistical analysis are different for different types of data, a clear understanding of various types of data is necessary for their efficient processing. Whereas broad types of data-quantitative and qualitative-are well known, some researchers struggle with the proper collation of ordinal data and quantitative categories. Additionally, some young researchers need guidance on preparing tables to communicate their results effectively. Graphics add muscles to the skeleton of data and need to be judiciously chosen. This article provides details of various types of data, their adequacy, and their proper collation, including a brief on tables and graphics. Almost all medical researchers carry out these activities - thus, this may have wide ramifications. Although this article primarily targets postgraduate students and young researchers, our interaction with a diverse group of researchers suggests that many experienced researchers may also find this article useful in the management of their data for reaching the right conclusions.","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"41-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A guide to empirical management of urinary tract infection in outpatient setting in a tertiary care institute: A study from Western India. 指导经验管理尿路感染门诊设置在三级保健机构：一项研究从印度西部。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-03-14 DOI: 10.4103/jpgm.jpgm_602_24

E Rajni, K Goyal, R Sharma

{"title":"A guide to empirical management of urinary tract infection in outpatient setting in a tertiary care institute: A study from Western India.","authors":"E Rajni, K Goyal, R Sharma","doi":"10.4103/jpgm.jpgm_602_24","DOIUrl":"10.4103/jpgm.jpgm_602_24","url":null,"abstract":"Introduction: Urinary tract infections make up a major proportion of infections encountered in outpatient setting in hospitals. Treatment is largely based on the epidemiology of locally prevalent flora. Selection of an appropriate antibiotic is crucial, as inappropriate use could contribute to an alarming rise in antimicrobial resistance.Materials and methods: This is a retrospective observational study conducted in a tertiary care teaching hospital. The urine samples were inoculated on cysteine lactose electrolyte-deficient (CLED) media and identification, and antimicrobial susceptibility testing of uropathogens was done using VITEK-2 system.Results: A total of 3893 urine samples were received during the study period, out of which 293 (7.5%) samples were reported positive, including 167 (57%) females and 126 (43%) males. The most common pathogenic isolates were Escherichia coli (191, 65.1%) followed by Klebsiella pneumoniae (42, 14.3%), Enterococcus spp (20, 6.8%), and Pseudomonas aeruginosa (19, 6.4%). Cotrimoxazole resistance was observed in 52.3% Escherichia coli and 47.1% Klebsiella pneumoniae isolates. About, 100% susceptibility was observed for fosfomycin. A total of 58.1% Escherichia coli and 40.7% Klebsiella pneumoniae isolates were found to be multi-drug resistant (MDR).Conclusion: According to this study, cotrimoxazole, cephalosporins, and fluoroquinolones need to be curtailed for empirical treatment of UTI in OPD because of high resistance. Nitrofurantoin and fosfomycin may be considered as drugs of choice for empirical therapy of lower UTIs.","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microbial profile and antimicrobial resistance patterns in ventilator-associated pneumonia (VAP): A cross-sectional study from Syria. 呼吸机相关性肺炎（VAP）的微生物特征和抗菌素耐药性模式：来自叙利亚的横断面研究。

Journal of postgraduate medicine Pub Date : 2025-01-01 Epub Date: 2025-01-02 DOI: 10.4103/jpgm.jpgm_565_24

K A Khalil, M Alsultan, N A Daher

{"title":"Microbial profile and antimicrobial resistance patterns in ventilator-associated pneumonia (VAP): A cross-sectional study from Syria.","authors":"K A Khalil, M Alsultan, N A Daher","doi":"10.4103/jpgm.jpgm_565_24","DOIUrl":"10.4103/jpgm.jpgm_565_24","url":null,"abstract":"Introduction: This study aimed to determine the bacterial profile and their antibiotic spectrum in patients with ventilator-associated pneumonia (VAP) and investigate the risk factors for VAP and the presence of multidrug-resistant (MDR) pathogens.Materials and methods: A cross-sectional study was included 105 patients with clinically suspected VAP in intensive care units (ICUs) of two university hospitals from Syria, between January 2023 and February 2024. Culture-positive included 69 samples (65.7%), which were classified based on post-intubation as early-onset (<5 days) or late-onset (≥5 days).Results: Gram-negative and Gram-positive bacteria were observed in 82.6% and 17.4%; respectively. Early and late-onset VAP was reported in 30 (43.5%) and 39 (56.5%) patients; respectively. The primary cause of early-onset VAP was Acinetobacter and Enterobacter , whereas Klebsiella and Acinetobacter were the main causes of late-onset VAP. Gram-negative showed a high resistance to fluoroquinolones (91.2%), carbapenems (78.9% for imipenem and 86% for meropenem), and amikacin (83.2%), while all were sensitive to colistin. Gram-positive was sensitive to tetracycline, vancomycin, linezolid, tigecycline, and trimethoprim-sulfamethoxazole. MDR was observed in 55 patients (79.7%) and in early (76.9%) and late-onset (83.3%) VAP. There were no risk factors favoring MDR or early compared to late-onset VAP.Conclusions: The study revealed a high prevalence of Gram-negative among VAP patients. A significant prevalence of MDR pathogens was observed in early and late-onset VAP, along with high resistance to carbapenems. This necessitates a reassessment of the current use of antibiotics and highlights the need for further studies to choose alternative treatments for empirical antibiotic coverage.","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0