Journal of the Asian Medical Students Association
Not a member yet
284 research outputs found
Sort by
A Comparison of Lowest Effective Dose (62.5 mg vs 125 mg) of Acetazolamide for Acute Mountain Sickness: A Meta-Analysis
Full text linkIntroduction
Acetazolamide is the recommended medication for the chemoprophylactic prevention of Acute Mountain Sickness (AMS). Acetazolamide is believed to speed up acclimatization primarily via enhancing ventilation through acidotic activation of the chemoreceptors in the brain. Acetazolamide has been shown to be efficient for AMS in dosages starting at 125 mg to 375 mg dosage twice daily. Over the past few decades, there have been repeated recommendations to reduce the dose of acetazolamide, often to lessen side effects such as headache, nausea, polyuria, and dysgeusia as well as to prevent misdiagnoses and unnecessary treatments.
Objective
To compare the effectiveness of Acetazolamide (62.5 mg vs 125 mg twice daily) for the prevention of AMS.
Methods
PubMed, Embase, Google Scholar, and reference lists were searched for clinical trials if they compared two dosages (62.5 mg vs 125 mg twice daily) of Acetazolamide for AMS. The extracted data were used to calculate the pooled odds ratios with a 95% confidence interval using the Mantel-Haenszel fixed-effects model while heterogeneity was calculated using I2 statistics. The quality of included trials was assessed using the Cochrane Collaboration tool.
Results
Two clinical trials included a total of 179 AMS patients (the 62.5 mg group [93 patients] and the 125mg group [86 patients]). Patients in the 62.5 mg group had a higher risk of AMS than patients in the 125mg group but were statistically non-significant. (OR: 1.16, 95%C.I.: 0.64-2.09, p=0.62, I2=0%). The side effects were similar between the two groups in both trials.
Conclusion
Based on the analysis, 62.5 mg of acetazolamide twice daily is non-inferior to the recommended dose of 125mg twice daily for the prevention of AMS. Further studies are needed along with placebo based on patients' characteristics and degree of prior acclimatization with the uniform endpoint altitude.
 
Bridging the Gap in Geriatric Healthcare: A Proposal for Universal Medical Equipment Coverage under “Med for All”
Full text linkIntroduction: The healthcare needs of geriatric patients are complex and multifaceted, often requiring specialized medical equipment for diagnosis, treatment, and management of chronic conditions. However, the current healthcare system is often ill-equipped to meet these needs, resulting in disparities in access to medical equipment and suboptimal health outcomes for geriatric patients. To address these challenges, we propose a new health policy for universal medical equipment coverage under the "Med for All" initiative.
Objective: The study aims to present the proposed health policy for universal medical equipment coverage and to assess its potential impact on healthcare outcomes.
Conclusion: The proposed system was found to be feasible and cost-effective, with the potential to improve access to medical equipment and health outcomes for geriatric patients. Its implementation could have a significant impact on improving healthcare outcomes for this vulnerable population.
Implications and Recommendations: The proposed policy has significant implications for policymakers, healthcare providers, and geriatric patients and their caregivers. It highlights the need for a more equitable healthcare system and ensures universal access to essential medical equipment. This includes investing in the necessary infrastructure and resources to ensure its success and working closely with stakeholders to address any potential challenges or barriers
A Decipher Longevity: Eat Seaweed for Longer Life - the Hidden Gem Butyric Acid is Key to Preventing Sarcopenia
Full text linkIntroduction:
Seaweed's high content of butyrate-producing bacteria can be considered to prevent sarcopenia, cancer, diabetes, and novel coronavirus disease 2019 (COVID-19). More than 20% of individuals aged 75 and above experience sarcopenia, leading to frailty, the third leading cause of death in Japan because of an aging society. Due to the past lack of minerals in Japanese water and Japan's suitable geography for seaweed production, seaweed has been consumed to compensate for this deficiency, making Japanese people less susceptible to sarcopenia. The average daily intake of dried seaweed per person in Japan is 13.2g, and it is recommended to consume between 5-10g to avoid nausea or constipation. It is said that only Japanese people have intestinal bacteria that can digest seaweed, but through continuous eating or by genetically manipulating the bacteria, people can become accustomed to digesting it.
Objectives:
There are only a few alternatives, such as stinky tofu or pickled vegetables made in rice bran, and a previous study suggests that protein intake is not related to muscle mass. Given Japan's long history of exporting dried foods and the accessibility of seaweed, it is suggested that other countries should incorporate seaweed into their food culture. 
Comprehensive Assessment of Full-face Helmet Utilization in Preventing Head and Neck Injury in Motorcycle Accidents : A Systematic Review
Full text linkIntroduction: Morbidity and mortality due to motorcycle accidents are still becoming a major problem that cannot be solved. A common cause of deaths in motorcycle road accidents is due to head-facial and neck injuries. One of the simple ways to overcome this problem is using a helmet, but the types of helmet that confer the best protection is not specified. This review aimed to evaluate the best type of helmet in reducing mortality and morbidity rate due to head-facial and cervical trauma.
Material and Methods: A Systematic review evaluating the most prominent helm in conferring protection was carried out using PRISMA statement guidelines. Studies search were conducted using search engine ScienceDirect, ProQuest, and PUBMED database with criterion papers published in English between 2009 to 2019 and comparing full face, partial face, and open face helmet effectivity in conferring protection. Appraisal tools of selected studies using Centre for Evidence-Based Medicine (CEBM) appraisal tools.
Result and Discussion : From the search, 1477 studies were identified and finally obtained 8 studies that fulfill the criterion. Studies are organized according to comparison of a full-face helmet with partial face helmet and full-face helmet with partial face helmet. Studies show that full-face helmet gives significant protection against head-facial and cervical injury. However, because many of the study criteria are not uniformed, the need for further study with better quality is a must.
Conclusion : Full-face helmet reduces head-facial and neck injuries better than other helmets in motorcycle accidents thus reducing the morbidity and mortality rate
A call for standardized undergraduate end-of-life care education in the post-COVID era: Standardized undergraduate end-of-life care education and COVID
No full textEnd-of-life care can effectively reduce psychological stress of near-death patients and smoothen the bereavement of patients’ relatives. However, the delivery of end-of-life care has been severely challenged by the pandemic due to an associated surge in patients. The major challenges include its adaptability to the pandemic and the enduring low level of competency in healthcare professionals. This prompts the question of whether the current end-of-life care education is sufficient for preparing future healthcare professionals in providing such services. This commentary highlights the importance of teaching end-of-life care at undergraduate level and suggests 11 learning points across five themes for consideration. 
AMSA International Report of Seventy-fifth Session of the WHO Regional Committee Meeting for South-East Asia
Full text linkHigh Altitude Pulmonary Edema in a Healthy Highlander Porter: A case report from Nepal
Full text linkIntroduction
High Altitude Pulmonary Edema (HAPE) is a form of non-cardiogenic pulmonary edema that develops due to rapid ascent of a non-acclimatized person from lowland to altitude more than 2500m. HAPE in porters is pretty uncommon with only a few cases reported till date.
Case Discussion
We report a case of 24-year porter, otherwise healthy with the ascending history from Lukla (2840m) to Pengboche (3980m) on day 1, Pengboche (3980m) to Pheriche (4240m) in day 2, and Pheriche (4240m) to Gorakshep (5140m) on day 3 presenting to Pheriche Aid Post on day 4 with shortness of breath at rest and with activity, cough with froathy sputum, headache, dizziness, and fatigue. On examination, he was tachypneic, tachycardic, with decreased breath sounds on the left side, and had no focal neurological deficits. His oxygen saturation was 40 percent, and his 2018 Lake Louise Acute Mountain Sickness (AMS) score was 8. Based on his clinical picture, a diagnosis of HAPE with moderate AMS was made. He was managed with oxygen support via face mask, nifedipine, acetazolamide, and ibuprofen at the aid post. Furthermore, he was advised for rapid descent to Kathmandu where he was managed further. A week later he was medically clear.
Conclusion
Even porters are at risk of suffering from high altitude sickness including HAPE. By increasing our consideration about high-altitude illness in porters we can more easily identify porters developing HAPE as well as other high-altitude illness and save porters from such life threatening but completely recoverable disease
Regulating the Temperature and Level of Cold Water Immersion as an Effective First-aid of Hyperthermia: A Systematic Review and Meta-Analysis
No full textIntroduction: Heat stroke, an emergency condition characterized by severe hyperthermia and organ dysfunction, causes significant morbidity and mortality if left untreated. Common in hot environments, the number of individuals exposed to high heatwave frequency is predicted to increase to 2.02 billion in 2050. Study in tropical countries estimated the mortality rate for heat-related illness was 19.5%. As one of the best first-aid, cold water immersion (CWI) was proven to have superior cooling rates, unsurpassed survival rates, and accessible implementation than ice water. However, to this date, the most effective temperature and the best level of cold water immersion have yet to be determined.
Objective: To investigate the effectiveness of cold water immersion in managing exertional heat stroke, including the most effective temperature and level of immersion.
Method: This study followed the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA). We systematically searched PubMed, Scopus, Cochrane, Wiley, and ProQuest for relevant literature up to 16 September 2022. The included documents were further assessed for risk of bias using the Cochrane Risk of Bias 2.0. We then pooled the effect estimates using random-effects meta-analysis.
Results: Nineteen randomized studies cumulating a total of 332 participants are included. Cold water immersion showed a beneficial effect on hyperthermia (MD=0.02 [95%CI: 0.01-0.03], p<0.001; I2=12%). The temperature of 14-16oC turned out to be the most optimal
temperature for cold water immersion, significantly increasing the body temperature by 0.02oC⋅min-1(95%CI: 0.01-0.03, p<0.001). Level of immersion above the iliac crest showed significant results (MD=0.02 [95%CI: 0.01-0.03], p<0.001; I2=24%) as well as below iliac crest (MD=0.02 [95%CI: 0.00-0.04], p<0.020; I2=0%).
Conclusion: Hyperthermia patients who were treated with cold water immersion significantly had superior cooling rates and it is potentially the best choice for the first aid. Implementation of optimal temperatures and immersion level through proposed guidelines is needed
How a Small City in India, Chandigarh, Controlled the COVID-19 Pandemic: Strategies Used and Lessons to be Learned: How a small city in India controlled the COVID-19 Pandemic
No full textWith the current COVID-19 pandemic sweeping across the globe, thousands have succumbed to the virus. Countries across the globe desperately try to take appropriate measures to prevent the spread of the coronavirus and to keep their population safe and healthy. While the predilection remains for older individuals, in countries where access to medical care is shorthanded, containing the virus is the best strategy. As many states and cities across the world grapple to combat the pandemic, this commentary focuses on the effective strategies implemented by one such city in India, named Chandigarh, in an effort to control the COVID-19 pandemic. By implementing strict curfews, social distancing and preventative measures, Chandigarh has effectively contained the COVID-19 pandemic. 
Potential of Medical Students for Ukrainian Refugees in COVID-19 Pandemic
No full textMedical students have the potential to provide necessary assistance to refugees from Ukraine and be part of the team medicine in a strained medical system during the COVID-19 pandemic. It is urgent to develop a system that allows refugees to feel safe and enables mutual understanding to prevent secondary damage