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2021 | January-June | Volume 4 | Issue 1

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EDITORIAL

Gurmeet Kaur

Battle of COVID-19

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:4] [Pages No:1 - 4]

Keywords: Covaxin, COVID vaccination, COVID-19, Covishield

   DOI: 10.5005/jp-journals-10070-0071  |  Open Access |  How to cite  | 

Abstract

It was in January 2021 the free vaccination against COVID-19 commenced in India and the government urged all of its citizens to get vaccinated which was expected to be the largest vaccination program in the world. Out of the various COVID-19 vaccines that were under various stages of clinical trials in India, four were developed in the country. Covishield (the name employed in India for the Oxford-AstraZeneca vaccine) and Covaxin, the home-manufactured vaccine produced by Bharat Biotech had received approval from the Drug Controller of India. Indian manufacturers had stated that they can meet the country's future needs for COVID-19 vaccines. The manpower and cold-chain infrastructure established before the pandemic was sufficient for the initial vaccination of 30 million healthcare workers and was strengthened further to cater to the entire population subsequently. The Indian government had taken urgent measures to expand the country's vaccine manufacturing capacity and has also developed an efficient digital system to address and monitor all the aspects of vaccine administration. It brings in the sequential events in the battle against COVID-19 in India.

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EDITORIAL

Bindu T Nair

Will Drones Revolutionize Health Care and Create Landmark Moments in History?

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:2] [Pages No:5 - 6]

Keywords: Drones, Health care, Geography, Rural, Delivery

   DOI: 10.5005/jp-journals-10070-0073  |  Open Access |  How to cite  | 

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ORIGINAL RESEARCH ARTICLE

Sandeep Kumar, Naresh Bansal, Narendra Kotwal, Rakhi Malhotra, Kiraninder Singh Brar

Perception about Virtual Endocrine Training among Endocrine Residents

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:4] [Pages No:7 - 10]

Keywords: Endocrine training, Perception of endocrine residents, Virtual learning

   DOI: 10.5005/jp-journals-10070-0067  |  Open Access |  How to cite  | 

Abstract

Background: COVID-19 has jolted the world order with the disruption of education at all levels. Present disruption in medical education has opened doors to virtual platforms. There is a dearth of studies, evaluating the perception of medical students about virtual learning. We have conducted a cross-sectional study to understand the perception of endocrinology residents with regard to virtual training. Materials and methods: This study is a cross-sectional online survey done in April 2020. A total of 46 endocrine residents, participated in this survey. Total 05 questions were asked in this survey, whether they believe virtual endocrine training is required in present COVID-19 times or not, the format of training, method of teaching, preferred topics requiring coverage, and online assessment. Results: All 46 (100%) participants agreed with the need for virtual endocrine teaching. Of the total 46 participants, their seniority of endocrine training was 1st year (n = 21, 45.65%), 2nd year (n = 17, 36.96%), and 3rd year (n = 8, 17.39%). Most preferred topics were endocrine imaging (n = 9, 19.57%) and nuclear medicine (n = 9, 19.57%) with pituitary as least preferred (n = 1, 2.17%). Of the total, 50% of residents wanted virtual faculty lectures, 47.8% opted for virtual clinical case discussions. Out of 46, 97.8% of residents wanted virtual platform informal assessment of students. There was no statistical significance between the choice of a topic among different endocrine residents according to the seniority of their training. Conclusion: Our study has shown that there is a felt need for virtual training among endocrinology residents in India. Imaging and nuclear studies are the specific topics that endocrine students want to learn through faculty lectures, irrespective of seniority as endocrine students. This study can be used while planning virtual endocrine curriculums in the future.

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ORIGINAL RESEARCH ARTICLE

Tehmina Parveen Syed, Samar Faheem, Shabnum Hassan

Medical Students’ Perception of Educational Environment and Effect of COVID-19 Pandemic on Learning

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:5] [Pages No:11 - 15]

Keywords: Coronavirus disease-2019 pandemic, Dundee Ready Education Environment Measure survey, Educational environment, Learning, Medical students

   DOI: 10.5005/jp-journals-10070-0068  |  Open Access |  How to cite  | 

Abstract

Aim and background: The educational environment of students plays a vital role in their well-being and academic performance. Evaluating it is of crucial concern while looking for areas of improvement. The Dundee Ready Educational Environmental Measure (DREEM) is one of the most suitable tools to evaluate the educational environment for health training settings. The coronavirus disease-2019 (COVID-19) pandemic has made online teaching commonplace and changed how traditional medical education is imparted, making the assessment of students’ perception of the environment especially necessary. Materials and methods: Final year medical students in Hamdard University were given a questionnaire to fill after an exam, which included the DREEM survey and open-ended feedback and suggestion questions about their experience learning during the COVID-19 pandemic. For the DREEM survey, the positive Likert scale items were scored from 0 to 4, and the negative items were scored in reverse. The data were analyzed using SPSS 26.0 software. For the analysis of open-ended responses, common themes were identified and grouped. Results: A total of 93 completed questionnaires were received. The mean total DREEM score was calculated as 119.85 ± 37.86. It was more positive than negative but had a high standard deviation. Student's perception of teachers scored the lowest, with a mean percentage of 55.25%. Student's academic self-perceptions scored the highest with 65.06%. The open-ended responses were grouped into five themes, with only nine students saying their online learning experience was positive. Conclusion: This study revealed that most students of Hamdard University scored their educational environment positively but do not enjoy online classes. For the future, medical schools need to improve the teacher–student interaction and have a more empathetic approach toward students. Medical schools also need to work on a more engaging teaching style, which includes adapting new methods for online teaching.

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ORIGINAL RESEARCH ARTICLE

Rahul Goel, Rolli Khurana, Shubham Dubey, Vijay Pal

Use of a Safe Nasal/Oral Sampling Aid in the COVID-19 Pandemic Era

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:3] [Pages No:16 - 18]

Keywords: Communicable diseases, Coronavirus disease-2019, Medical device, Sampling

   DOI: 10.5005/jp-journals-10070-0069  |  Open Access |  How to cite  | 

Abstract

Background: Coronavirus disease-2019 (COVID-19) was first detected in Wuhan, China, after which it quickly spread throughout the world despite several precautions. It has been noted that the healthcare workforce is most susceptible to it. Maximum exposure to them was observed at the time of collection of the mucous sample. Similar activities such as nasal/oral endoscopy or biopsies also put the healthcare workers in harm's way. Aims and objectives: A simple device was developed which would allow nasal or oral mucous sampling to be done without the patient having to take off the face mask. This would then be tested in field settings to ensure acceptability, efficacy, and safety to healthcare workers. Materials and methods: A prototype device consisting of four parts was designed. The device can clip onto the surgical mask using the disks. Once the trocar has punctured the mask, the valve can be opened to allow a swab-stick or endoscope of up to 5 mm to be passed through it. This valve creates a tight seal when released and decreases aerosol spread in the instance that the patient coughs or sneezes. Results: One hundred and fifty patients who reported for COVID testing at our hospital and 89 patients who reported for nasal or oral endoscopy were sampled or examined using this device. Minor difficulties of the loose fit of the device on the mask, tight valve, and inability to find nasal opening were noted. Discussion: Our team was able to successfully develop an affordable and effective device—nasal/oral sampling aid (NOSA). Our preliminary trials found it to be dramatically effective for patient and doctor safety. It reduced instances of aerosol dispersion and gave security to the entire sampling process.

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ORIGINAL RESEARCH ARTICLE

Shubhangini Sachdeva, Sridhar Mangalesh, Sharmila Dudani

COVID-19 Vaccine Hesitancy in the Adult General Population of India

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:5] [Pages No:19 - 23]

Keywords: Coronavirus disease-2019, Infection, Pandemic, Vaccination refusal, Vaccine

   DOI: 10.5005/jp-journals-10070-0070  |  Open Access |  How to cite  | 

Abstract

Aim and background: Two vaccines for coronavirus disease-2019 (COVID-19), by Bharat Biotech and Serum Institute of India, have been approved by the Indian Government for administration. This study attempts to analyze vaccine hesitancy in the general adult population of India. Materials and methods: A pan-India cross-sectional survey, adapted for GoogleForms®, was circulated before the rollout of vaccines to assess vaccine hesitancy. Continuous variables are expressed as mean ± SD and categorical variables as a percentage. The Chi-square test was used for associations. Results: Seven hundred and sixty-two responses were analyzed. 27.2% of respondents demonstrated vaccine hesitancy. 59.4% of vaccine acceptors preferred getting the vaccine from government healthcare establishments over private-sector establishments. No significant associations were observed between vaccine acceptance and age or gender. Those who accepted the vaccine were more likely to believe that it should be compulsory (p = 0.00001) and safety measures should be continued even after vaccine administration (p = 0.043). IT-related professionals showed 82.6% vaccine acceptance, healthcare professionals displayed 73.5%, while lawyers showed 53.3% acceptance. There was no association between vaccine acceptance and being a frontline worker, previously having COVID-19, or having a family member who suffered from COVID-19. Despite Delhi and Maharashtra being the highest COVID-19 burden areas, the general population of these two states was more likely to refuse the vaccine than the residents of other states (p = 0.027). Conclusion: This study identified the prevalence of vaccine hesitancy in the Indian population. Consistent dialogue between the government and the public is essential for trust-building. Educational intervention through an evidenced-based approach by government authorities is the need of the hour.

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ORIGINAL RESEARCH ARTICLE

Urvashi Mishra, Deepika Sethi, Daljeet Kaur, Ashwani Sethi

Endoscopic vs Microscopic Myringoplasty: A Comparative Study of 100 Cases

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:4] [Pages No:24 - 27]

Keywords: Endoscopic, Microscopic, Myringoplasty, Postaural approach, Temporalis fascia

   DOI: 10.5005/jp-journals-10070-0072  |  Open Access |  How to cite  | 

Abstract

Introduction: The surgical procedure of myringoplasty is performed for the repair of tympanic membrane perforations. This study aims to compare endoscopic myringoplasty with microscopic myringoplasty surgery based on uptake of graft, hearing improvement in terms of pure tone audiograms performed preoperatively and postoperatively, complications in the postoperative period, and subjective cosmetic results. Materials and methods: Between January 2019 and December 2019, 100 patients were subjected to myringoplasty, 50 performed endoscopically and 50 performed microscopically. Results were compared 3 months following the surgery. Results: This article reveals that there was no statistically significant difference between the two groups regarding the success rate. In this study, the endoscopic myringoplasty group shows fewer incidences of postoperative pain and better cosmetic results. Conclusion: Most of the disadvantages of the microscope can be overcome by an endoscope by virtue of its wide-angled telescopic and magnified view. However, the endoscope has the disadvantages of a comparative lack of depth perception and one-handed technique. These can be easily overcome with practice. Thus, endoscopic myringoplasty may be a good alternative to microscopic myringoplasty. Clinical significance: The study gives significant insight into the comparative outcomes of endoscopic and microscopic myringoplasty.

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CASE REPORT

Dr Novy Gupte, Sapna Pradhan

Pandrug-resistant Infections

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:2] [Pages No:28 - 29]

Keywords: Acinetobacter, Antimicrobial resistance, Antimicrobial stewardship, Enterococcus, Extensive-drug resistance, Klebsiella pneumoniae, Pandrug resistance, Proteus, Pseudomonas aeruginosa, Staphylococcus aureus

   DOI: 10.5005/jp-journals-10070-0065  |  Open Access |  How to cite  | 

Abstract

Background: Increasing antibiotic resistance, usually from irrational pharmacotherapy, poses a grave challenge to clinicians in managing multidrug-resistance infections. Aim and objective: To focus attention on the rising incidence of pandrug-resistant infections, related issues and concerns, and their containment. Materials and methods: The short communication is prompted by the recently reported in vitro sensitivity of gram-negative bacteria to a combination of ceftriaxone + sulbactam + EDTA. Appropriate observations from literature are cited to complement the outcome of the said study. Results: Pandrug resistance (PDR) is defined as a non-susceptibility of the bacteria to all antimicrobial agents in all antimicrobial categories. This is not true that it is restricted to only gram-negative bacteria. Staphylococcal aureus, a gram-positive bacteria, may too develop such resistance. The in vitro sensitivity observations do not necessarily get reflected in actual clinical effectiveness and efficacy. Therapy is a herculean task. Judicious use of antibiotics and strict infection control measures, preferably as a part of an antibiotic stewardship program, are mandatory to reduce the prevalence of PDR, nay the drug resistance as such. Conclusion: Pandrug resistance, meaning resistance to all classes of antibiotics, can develop not only in the case of gram-negative bacteria but also gram-positive bacteria, like S. aureus. It is best prevented rather than treated. Clinical significance: Implementation of the antibiotic stewardship program, mainly comprising rational antibiotic therapy, has the potentials to go a long way in safeguarding against PDR, nay antibiotic resistance as such.

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SHORT COMMUNICATION

George C Ambooken, Venigalla Sri Krishna

Thoracic Paravertebral Block as an Alternative to General Anesthesia in Patients with Hypertrophic Cardiomyopathy for Elective Breast Surgeries: A Case Series Study

[Year:2021] [Month:January-June] [Volume:4] [Number:1] [Pages:3] [Pages No:30 - 32]

Keywords: Breast surgeries, Hypertrophic cardiomyopathy, Paravertebral block

   DOI: 10.5005/jp-journals-10070-0066  |  Open Access |  How to cite  | 

Abstract

Hypertrophic cardiomyopathy (HOCM) is a cardiac disease characterized by asymmetric hypertrophy of the interventricular septum (IVS), causing intermittent obstruction of the left ventricular outflow tract (LVOT). Sympathetic stimulation during general anesthesia (GA) in HOCM patients poses the risk of sudden intraoperative death. It is pertinent to appreciate that surgery and anesthesia often complicate the perioperative outcome if adequate monitoring and proper care are not taken. Therefore, a complete understanding of the pathophysiology, hemodynamic changes, and anesthetic implications of HOCM is required for a successful perioperative outcome. Regional anesthesia using paravertebral block (PVB) provides an excellent alternative to GA in HOCM patients undergoing carcinoma breast surgery. We hereby describe the perioperative management of three patients of HOCM, with PVB as the preferred anesthetic modality, which resulted in excellent intraoperative conditions with adequate postoperative analgesia and negligible hemodynamic alterations.

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