Journal of postgraduate medicine最新文献

{"title":"Medullary nephrocalcinois and primary hyperaldosteronism - A rare and under recognised association.","authors":"R John, J T Johnson, R R Rajan, F Jebasingh","doi":"10.4103/jpgm.jpgm_296_24","DOIUrl":"10.4103/jpgm.jpgm_296_24","url":null,"abstract":"<p><strong>Abstract: </strong>Medullary nephrocalcinosis is an uncommon manifestation of primary hyperaldosteronism (PHA) and the exact etiology of this association is still debated. Here we report three cases of PHA with medullary nephrocalcinosis and how medullary nephrocalcinosis in one patient led to misdiagnosis as renal tubular acidosis (RTA). Although PHA and RTA can share overlapping symptoms, careful evaluation of clinical presentation, biochemical tests, and imaging studies are essential to differentiate between the two conditions and ensure appropriate management. Also, awareness of this uncommon manifestation of PHA is essential to avoid misdiagnosis as tubulopathy, as this may delay the treatment.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"166-168"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918413","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}

{"title":"A misplaced epicutaneo-caval catheter presents with abdominal wall cellulitis in a neonate.","authors":"A G Gore, P R Raghavendra, S Nair, A Haribalakrishna","doi":"10.4103/jpgm.jpgm_152_24","DOIUrl":"10.4103/jpgm.jpgm_152_24","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"182-183"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977548","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}

{"title":"Factors influencing academic failure rate among first-year Indian medical students who experienced competency-based medical education curriculum during the COVID-19 pandemic.","authors":"D Lalwani, S Kalawadia, N Darooka, S Rao, M Hirkani","doi":"10.4103/jpgm.jpgm_925_23","DOIUrl":"10.4103/jpgm.jpgm_925_23","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of the study was to assess the factors that influenced the increased failure rate among first-year Indian medical students who appeared for the Maharashtra University of Health Science (MUHS) summative university examination, having experienced the competency-based medical education (CBME) curriculum for the first time amid the coronavirus disease (COVID-19) pandemic.</p><p><strong>Methods: </strong>A retrospective cross-sectional online questionnaire-based study was undertaken between July 2021 and November 2021, in which first-year Indian medical students who were enrolled in the Bachelor of Medicine, Bachelor of Surgery (MBBS) program in the year 2019 and appeared for the MUHS summative university examination in February 2021 were invited to participate. Analysis was done using JASP (v0.16.0.0), and the odds ratio for failure was calculated at a significance level of P < 0.05.</p><p><strong>Results: </strong>Responses were obtained from 360 individuals, of whom 74.5% had passed and 25.5% had failed (n = 360). The odds of failure in first-year MBBS summative university examination was higher in students with irregular Internet access, irregular device access, an unsupportive peer environment in college, a National Entrance cum Eligibility Test score below 500, an unsupportive family environment during the lockdown, severe stress, severe depression, testing positive for COVID-19 before the exam, death in the family during the exam, and failing in terms and prelims and students of male gender ( P < 0.01).</p><p><strong>Conclusion: </strong>The total failure rate of 27% in the MUHS examination was mainly attributed to interplay between the student's mental health, lack of devices or Internet, and the changed assessment part of the CBME curriculum. Surprisingly, lecture frequencies, teaching patterns, and study resources did not influence the failure rate. These results can be used to formulate interventions that will help to improve academic performance and mental health students and thus help them adapt to the new curriculum.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"135-142"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790664","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}

{"title":"Improving safety: Neuraxial blockade guided by thromboelastography for patients with uncertain coagulation profile.","authors":"A Kumar, A N Deshmukh, C K Pandey, N Chaudhary","doi":"10.4103/jpgm.jpgm_361_24","DOIUrl":"10.4103/jpgm.jpgm_361_24","url":null,"abstract":"<p><strong>Abstract: </strong>Neuraxial blockade procedures are essential for anesthesia and pain management but pose risks in patients with uncertain coagulation profiles. Traditional coagulation tests often fail to predict bleeding risks associated with neuraxial blockade. Thromboelastography (TEG) offers real-time insights into coagulation status, potentially improving safety outcomes. In this case series, six patients underwent neuraxial blockade guided by TEG analysis. An individualized anesthetic plan was formulated based on TEG findings to mitigate bleeding risks while ensuring pain management. Tailoring anesthetic techniques to real-time TEG data improved safety outcomes with minimized bleeding complications and satisfactory pain control. In conclusion, neuraxial blockade guided by TEG enhances safety in patients with uncertain coagulation profiles. Further studies are needed to validate benefits in broader clinical settings.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977578","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}

{"title":"Primary central nervous system neuroblastoma mimicking a meningioma: A case report.","authors":"K Yadav, P K Sharma, D K Singh, V K Mishra","doi":"10.4103/jpgm.jpgm_58_24","DOIUrl":"10.4103/jpgm.jpgm_58_24","url":null,"abstract":"<p><strong>Abstract: </strong>Neuroblastomas are the most common extracranial solid tumor in the pediatric age group (~8%-10% of childhood neoplasms). Most cases of intracranial neuroblastomas occur due to metastasis from some primary extracranial sites and are known as secondary neuroblastomas. However, the occurrence of primary central nervous system neuroblastomas (PCN-NB) is very rare, and only a few cases and case series have been reported in the literature. PCN-NB is mainly an intra-axial pathology, and extra-axial involvement is mainly due to metastasis from some extracranial primary site with involvement of the skull bone. Herein we report a case of a 23-year-old female having a large extra-axial space-occupying lesion in the right frontal region that was mimicking a meningioma, and surprisingly the histopathology was suggestive of a supratentorial neuroblastoma. A right frontal craniotomy was made, and Simpson's grade 1 excision of the tumor was done. The excised tissue was sent for histopathological examination. PCN-NB located extra-axially are extremely rare to occur. Due to inconsistent radiological imaging, it becomes very difficult to diagnose these tumors preoperatively, and these should be kept in mind as one of the differential diagnoses of extra-axial intracranial space-occupying lesions. Histopathological examination is crucial in diagnosing the intracranial neuroblastomas.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"178-181"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592499","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}

{"title":"Acute disseminated encephalomyelitis with coexisting neurocysticercosis in an 11-year-old boy: An unusual occurrence.","authors":"D. Rajiv, S Jain, S. Karande","doi":"10.4103/jpgm.jpgm_926_23","DOIUrl":"https://doi.org/10.4103/jpgm.jpgm_926_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":"20 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140658560","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":"Large language models and the future of academic writing.","authors":"P. Nayak, N. Gogtay","doi":"10.4103/jpgm.jpgm_823_23","DOIUrl":"https://doi.org/10.4103/jpgm.jpgm_823_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":"49 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140656700","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":"Bicarotid trunk and severe kinking of right common carotid artery presenting with large intracranial hemorrhage.","authors":"S. J. Chen, S S Chang, N. H. Meng","doi":"10.4103/jpgm.jpgm_891_23","DOIUrl":"https://doi.org/10.4103/jpgm.jpgm_891_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":"27 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672501","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":"Periosteal reaction in jugular foramen secondary to ipsilateral internal jugular vein thrombosis.","authors":"P. V. Patil","doi":"10.4103/jpgm.jpgm_763_23","DOIUrl":"https://doi.org/10.4103/jpgm.jpgm_763_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140688413","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":"Use of ROC curve analysis for prediction gives fallacious results: Use predictivity-based indices.","authors":"A. Indrayan, R. K. Malhotra, M. Pawar","doi":"10.4103/jpgm.jpgm_753_23","DOIUrl":"https://doi.org/10.4103/jpgm.jpgm_753_23","url":null,"abstract":"ABSTRACT\u0000The area under the ROC curve is frequently used for assessing the predictive efficacy of a model, and the Youden index is commonly used to provide the optimal cut-off. Both are misleading tools for predictions. A ROC curve is drawn for the sensitivity of a quantitative test against its (1 - specificity) at different values of the test. Both sensitivity and specificity are retrospective in nature as these are indicators of correct classification of already known conditions. They are not indicators of future events and are not valid for predictions. Predictivity intimately depends on the prevalence which may be ignored by sensitivity and specificity. We explain this fallacy in detail and illustrate with several examples that the actual predictivity could differ greatly from the ROC curve-based predictivity reported by many authors. The predictive efficacy of a test or a model is best assessed by the percentage correctly predicted in a prospective framework. We propose predictivity-based ROC curves as tools for providing predictivities at varying prevalence in different populations. For optimal cut-off for prediction, in place of the Youden index, we propose a P-index where the sum of positive and negative predictivities is maximum after subtracting 1. To conclude, for correctly assessing adequacy of a prediction models, predictivity-based ROC curves should be used instead of the usual sensitivity-specificity-based ROC curves and the P-index should replace the Youden index.","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687906","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}