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2019 | July-December | Volume 2 | Issue 2

Editorial Preface

Brig (Dr) Devendra Arora

Editorial Preface

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:1] [Pages No:00 - 00]

PDF  |  DOI: 10.5005/joma-2-2-v  |  Open Access |  How to cite  | 

EDITORIAL

R Chaturvedi, Rajshree R Gupta

Foundation Course for Undergraduate Medical Education Program: A Stitch in Time

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:2] [Pages No:37 - 38]

Keywords: Communication skills, Ethics, Professionalism

PDF  |  DOI: 10.5005/jp-journals-10070-0040  |  Open Access |  How to cite  | 

Original Article

Charu Mohan, Bishamber D Toora, Surendra K Gulati, Bindu T Nair, Priyanka Banerjee, Archna Rautela

Participant Perception of a CME cum Hands-on Training Workshop on Small Group Teaching Methodologies at a North Indian Medical College

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:5] [Pages No:39 - 43]

Keywords: Education Medical, Faculty, Learning

PDF  |  DOI: 10.5005/jp-journals-10070-0038  |  Open Access |  How to cite  | 

Abstract

Introduction: To overcome the demerits of the traditional lectures and to promote interactive teaching learning, the Medical Council of India has introduced small group teaching and learning as an essential component of the newly introduced competency-based medical education (CBME) curriculum. Workshops are an effective method of faculty training; they can be conducted in resource poor settings, can train multiple participants at once, can target multiple topics in a short span of time, and are cost- and time effective even for the participants. Aim: The aim of this study was to collect and analyze feedback from the participants of a Hands-On Training Workshop on Small Group Teaching Methodologies. Materials and methods: A 1-day continuing medical education (CME) cum hands-on-training workshop was conducted at our medical college. The CME was attended by 65 delegates and consisted of 5 hands-on training workshops on fishbowl, case-based learning (CBL), snowball, jigsaw, and role play, respectively. At the end of the CME, the link to the online feedback form was shared with the participants and they were asked to fill and submit the feedback forms at the earliest. Results: Forty-seven participants responded to the online feedback form. A majority of respondents were of the opinion that the workshop was well organized. Respondents also appreciated the seating arrangements, the color coding in jigsaw, and the case scenarios in CBL and role play. Conclusion: The authors feel that more such workshops should be organized across India to better prepare the faculty for implementation of small group teaching learning under the CBME curriculum.

Original Article

Chenicherry Manju, Kusum Singla, Jyotismita Pathak

Evaluation of Stressors in Undergraduate Students in a Medical College in North India

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:4] [Pages No:44 - 47]

Keywords: Academic stress, Curriculum, Medical students, Nonacademic stress, Stressors, Teaching institution

PDF  |  DOI: 10.5005/jp-journals-10070-0035  |  Open Access |  How to cite  | 

Abstract

Objectives: To identify the sources of stress among undergraduate students in a medical college. Design: Cross-sectional study. Settings: The study was conducted at Army College of Medical Sciences, Delhi Cantt, New Delhi, India. Materials and methods: Subjects: subjects included second-year medical students (both male and female) enrolled in the college during the year of study. Interventions: a predesigned structured questionnaire was used to collect information regarding the academic and nonacademic sources of stress. Result: A total of 103 students of the second year were approached; of which 84 consented to take part in this study. The questionnaire included general information of the students including their locality, medium of schooling, and interaction with parents and mentor. The major academic stressors identified were amount of syllabus to learn (42.86%), competition for marks (26.19%), long working hours (22.89%), and frequent examinations (17.07%). Teaching language was not found to be a difficulty for the students. The nonacademic stressors identified were time management (28.57%), decreased recreation period (15.85%), parental expectations (14.29%), stay away from home (13.10%), and health conditions (11.90%). Majority of the students identified food in the mess as a main nonacademic difficulty (33.73%). Conclusion: This study found that amount of syllabus was a major academic stress, and food in the mess was a major nonacademic stressor. The possible sources of stress found in this study can be a preliminary step toward developing solutions for stress management and stress prevention in medical students which could help in developing a new generation of stress-free doctors capable of effectively providing high-quality medical care to the community at large.

Original Article

Rakesh Khajuria, Sumeena Bajaj, Jugal Kishore, Divyansh Bajaj

Socioepidemiological Determinants of Human Immunodeficiency Virus associated Tuberculosis Coinfection in Northern India: A 1:2 Matched Case Control Study

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:6] [Pages No:48 - 53]

Keywords: Human immunodeficiency virus infection-associated tuberculosis coinfection, people living with HIV-AIDS, Tuberculosis,Antiretroviral therapy, Human immunodeficiency virus

PDF  |  DOI: 10.5005/jp-journals-10070-0036  |  Open Access |  How to cite  | 

Abstract

Aims: Our study was designed to assess the sociodemographic correlates of human immunodeficiency virus infection-associated tuberculosis (HIV-TB) coinfection and elucidate its risk factors among patients attending a tertiary healthcare facility in Northern India. Materials and methods: A 1:2 case–control study, wherein the case group (patients with HIV-TB) was compared with two control groups: I group comprising patients with active tuberculosis (TB) [but without human immunodeficiency virus (HIV)] and II group comprising HIV patients (who did not develop active TB during follow-up). Our questionnaire was designed to obtain data based on sociodemographic and detailed medical history. Results: Significant differences were observed on comparing gender, age, educational level, per capita income, place of residence, and occupational profile between case group and control group I. Case group was more likely to reside in urban areas (p = 0.001) and had a lower average level of formal education (p = 0.009) as compared to control group II. Conclusion: We found patients in the coinfected group to differ significantly from patients with active TB alone, but the trends were similar to the control group I. The most frequent high-risk behavior was observed to be unprotected sexual activity, which is in concordance with the national estimates by National AIDS Control Organization (NACO) and World Health Organization (WHO). Clinical significance: To minimize the prevalence of HIV-TB, controlling HIV transmission and disease progression in people living with HIV-AIDS (PLHAs) is crucial. Moreover, if the life expectancy of PLHAs is to be improved, HIV should be diagnosed early in the natural history of infection.

Original Article

Amit Sreen, Prafull Sharma, Vivek Guleria

Risk Factor Profile, Clinical and Vascular Territory Involved in Patients of Stroke Presenting to a Tertiary Care Hospital in India Over 1 Year

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:4] [Pages No:54 - 57]

Keywords: Brain ischemia, Risk factors, Stroke

PDF  |  DOI: 10.5005/jp-journals-10070-0037  |  Open Access |  How to cite  | 

Abstract

Introduction: Recent rapid socioeconomic changes have led to a concomitant change in people\'s lifestyle, leading to work-related stress and altered food habits which leads to enhanced atherosclerosis and strokes. Aim: To analyze the risk factor profile, clinical, and vascular territory involved in all patients of stroke presenting to tertiary care hospital over 1 year. Materials and methods: All cases of fresh stroke reporting, referred, or transferred to this hospital (within 2 weeks of ictus) who were more than 15 years of age were included. A detailed history was obtained regarding time and mode of onset of symptoms and risk factor details following clinical evaluation, patients underwent complete hemogram, blood sugar levels (fasting and post prandial), lipid profile, and other metabolic parameters. All patients were subjected to chest radiography 12-lead electrocardiography (ECG) and two-dimensional (2D) echocardiography to detect cardiac abnormalities. Neuroimaging was performed in all in the form of noncontrast computed tomography (CT) head and magnetic resonance imaging (MRI) brain, while magnetic resonance angiography (MRA) brain was carried out in selected cases. Results: Ischemic strokes were higher (77.4%) when compared with hemorrhagic strokes (22.6%). The maximum number of patients was in the age group of 51–60 years (37.15%). Males were more affected than females, both in ischemic as well as hemorrhagic stroke. The most common risk factor was hypertension (65.35%), followed by smoking (46.26%) and diabetes (21.05%). Alcohol usage was more significant in cases of hemorrhagic stroke (11.14%). More number of patients reported stroke symptoms on awakening in ischemic stroke. Anterior vascular territory was more involved (76.8%). Left hemiparesis was more common (62.05%), and aphasia was seen in 27.97% of patients. Middle cerebral artery (MCA) territory was most commonly involved (78%), and gangliocapsular region was most commonly affected (41.54%) Lacunar infarcts were seen in 22% cases. In hemorrhagic stroke, the basal ganglia was most commonly involved (56.17%), followed by thalamus (26.03%). Conclusion: Developing countries like India are facing burden of lifestyle diseases. Stroke is leading cause of death and disability in India.

Original Article

Anshita Batta

Importance of English in Medical Education

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:3] [Pages No:58 - 60]

Keywords: Medical English,Communication, Communication skills

PDF  |  DOI: 10.5005/jp-journals-10070-0042  |  Open Access |  How to cite  | 

Abstract

For speedy developments in the universe of medicine, the medical education, the Medical Council of India (MCI) has devised competency-based undergraduate curriculum (CBUC) for medical graduation. The new curriculum is proposed to be “more learner-centric, patient-centric, gender-sensitive, outcome-oriented and environment appropriate in keeping with the global trends.” The outgoing medical graduate has to perform multiple roles as a clinician, leader of healthcare team, communicator with patients, families, colleagues, and community and become a life-long learner committed to continuous improvement. This is expected to be achieved through a foundation course that would allow the students from diverse educational streams and backgrounds to transition appropriately. The course would focus on “Attitude, Ethics and Communication (AETCOM) Competencies.” He should be able to demonstrate ability to establish professional relationships with patients and families that are positive, understanding, humane, ethical, empathetic, and trustworthy. He must also demonstrate ability to communicate with patients in a manner respectful of patient\'s preferences, values, prior experience, beliefs, confidentiality, and privacy. Obviously for gaining expertise in medicine and medical communication, language that is commonly and internationally well understood is English. Need for communicating in English in India is more important. True, that most students admitted to medical colleges are selected through a national process of competition, they come from diverse backgrounds. Many of them might have taken tests in their vernacular because they were in vernacular schools and studied most of the subjects, including biology, in vernacular and not in English. More than education of language, communication skills are more important communication is the ability you use when giving and receiving different kinds of information. Some examples include communicating new ideas, feelings, or even an update on your project. Communication skills involve listening, speaking, observing, and empathizing.

REVIEW ARTICLE

Sachin Kishore, Priyanka Banerjee, Sanjay Singh Kaira

Clostridioides difficile: An Overview of Current Diagnostic and Infection Prevention Modalities

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:4] [Pages No:61 - 64]

Keywords: Cell cytotoxicity neutralization assay, Clostridioides difficile infection, Enzyme immunoassays, Glutamate dehydrogenase, Nucleic acid amplification test, Toxigenic culture

PDF  |  DOI: 10.5005/jp-journals-10070-0043  |  Open Access |  How to cite  | 

Abstract

Clostridioides difficile, previously known as Clostridium difficile, has been recognized as an emerging nosocomial pathogen in recent years. Among hospitalized patients, it\'s a leading cause of increased mortality and morbidity. Earlier C. difficile infection (CDI) was not recognized for high morbidity and prolonged hospital stay. But, in last few decades due to uncontrolled usage of antibiotic and immunosuppressive drugs, CDI has increased in frequency and severity. Besides nonmodifiable risk factors, exposure to antibiotics is a single most modifiable risk factor. Various methods for diagnosis of CDI are known these days like toxigenic culture (TC) and cell cytotoxicity neutralization assay (CCNA), available only in reference laboratories. Other methods like enzyme immunoassays (EIA) for toxins A, B, and/or glutamate dehydrogenase (GDH) and nucleic acid amplification tests (NAATs) are routinely used for CDI diagnosis; however, each diagnostic test has some limitations. Early CDI diagnosis is critical for early treatment and effective infection control measures to reduce the morbidity and mortality and preventing outbreak. Poor infection control practices further contribute in spread of CDI and environmental contamination by spores of C. difficile. Therefore, a correct and authentic diagnostic modality that can be used to characterize CDI vs colonization and making an effective infection control policy for CDI are urgently needed for prevention of occurrence of CDI.

LETTER TO THE EDITOR

Poonam Agrawal

Nanotechnology in Medicine: “Future in Tiny Hands”

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:2] [Pages No:65 - 66]

Keywords: Nanomedicine, Nanotechnology, Respirocytes,Microvivors

PDF  |  DOI: 10.5005/jp-journals-10070-0041  |  Open Access |  How to cite  | 

Abstract

Nanomedicine is the application of nanotechnology for treatment, diagnosis, and monitoring of the course of disease. Though it might be utilized for many diseases as well as enhancement of normal physiology, its utilization for the treatment of cancer is very promising. Today\'s cancer treatment is facing major challenge in terms of toxicity of the chemotherapeutic agents. Toxicity of chemotherapeutic agents is mainly due to the lack of efficacious drug delivery following systemic drug administration. Site-specific drug delivery and tailored release of these chemotherapeutic agents is the need of the hour. Nanomedicine has come as an answer to these issues, where nanoparticles are utilized for site-specific delivery of these chemotherapeutic agents. Both active and passive targeting of the drug is utilized for such delivery of the drug to the cancer cells.

LETTER TO THE EDITOR

Deepak Dwivedi, Priya Taank

Ultrasound-assisted Rare Case of Misplaced Hemodialysis Catheter

[Year:2019] [Month:July-December] [Volume:2] [Number:2] [Pages:2] [Pages No:67 - 68]

PDF  |  DOI: 10.5005/jp-journals-10070-0039  |  Open Access |  How to cite  | 

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