The ESRF Research Journal for Undergraduate Medical Students
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Diagnosis by ICD coding on discharge and death: A medical record-based study on in-patients of a Medical College and Hospital of West Bengal, India
Full text linkIntroduction: Medical records of hospitals are primary and basic source of health information. It provides background and clinical diagnosis, treatment undertaken, complications, length of stay, laboratory date etc. which plays an important role in planning health care services. International Classification of Diseases (ICD) helps in managing health information, data standardization, and classification of patients’ health information maintaining uniformity globally.
Objectives: To find out the socio-demographics, final diagnosis and status of ICD coding at discharge or death.
Materials and Methods: It was an analysis of one-month secondary data, 3002 in number from Medical Records Department of a Medical College of Eastern India. Along with this, two key informants (KI), one medical and one non-medical were interviewed. UCINET was used for network analysis besides descriptive statistics.
Results: Mean age of participants was 53.03±15.89 years, 2407 (80.18%) received medical management and 595 (19.82%) underwent surgical interference. In 164 records ICD coding was missing, among them 131 were left against medical advice, 24 died during the hospital stay and 9 patients were discharged as cured. Thematic analysis of gaps, concerns and solutions some consensus was found as, lack of corroboration, no linkage between prescriber and coder, manpower shortage, the need of training and so on.
Conclusions: ICD is one of the most scientific, universally acceptable and important classification systems having overarching applicability. Interdepartmental collaborative record updatation by trained manpower is very much needed for making the hospital record keeping system more sound and stringent
The pattern of dermatological disorders among patients attending the Dermatology outpatient department of a tertiary care hospital in Kolkata
Full text linkIntroduction
The pattern of the dermatological disease varies from country to country and even between geographical areas within a country. This present study aims to elucidate the dermatological patterns observed in a tertiary care hospital setting in West Bengal, India, while concurrently examining the sociodemographic characteristics of the patient population.
Materials and methods: This descriptive observational study with cross sectional design, was conducted among 214 patients, in the Dermatology outpatient department NRSMCH, Kolkata, between 01/02/24-28/02/24. The patients were selected based on a systematic random sampling method. The dermatologists on duty on the day of data collection identified the diagnosis. A predesigned pretested schedule was used for recording the variables. All collected data were entered into Microsoft Excel, cleaned, checked for consistency and analyzed using SPSS (version 20).
Results: Most patients were male (57.9%), Hindu (59.3%), having education upto primary level (37.4%) and belonging to SES class IV (37.4%). Self-reported co-morbidities were present in 27.6% of the patients. Almost one fifth (18.7%) of the patients had similar disease among family members during the same time. The study population could be almost equally divided between infective (49.5%) and non-infective cases (50.5%). The most common diagnosis overall was tinea (23.8%). Tinea was also the commonest infectious/ parasitic disease in the study population, followed by Scabies (12.6%). Among non-infectious diseases, the commonest was dermatitis (seborrheic, atopic and unspecified) seen in 13.1% of the patients, followed by acne vulgaris (8.9%) and pigmentation disorders (including vitiligo/ melasma/ post inflammatory tatoo pigmentation) (5.1%).Higher proportion of patients in the infectious group were in the age group 35-44 years (41.9%), than the non-infectious group where the highest proportion of patients were in the 15–34-year age group (52.4%). Significantly higher proportion of patients with infectious disease had a family member suffering from similar diseases at the same time (26.7% vs 11%, p=0.003).
Conclusion: The findings of this study highlight the fact that along with medical treatment, health education is also necessary to curb the spread of dermatological diseases. Preventive and curative health services like awareness regarding hygiene, achieve a considerable reduction in the prevalence of skin disorders
Status of childhood vaccination practice in a fixed-session site of a Medical College of Eastern India
Full text linkIntroduction: Vaccination is most cost-effective munitions and National Immunization Schedule (NIS) is providing protection to under-five children against 11 diseases currently. Still gap of nearly 1/3rd unvaccinated children is remaining despite various initiatives, campaigns, and special drives. Objective: To assess status of vaccination service and awareness among various stakeholders of an immunization clinic in a medical college hospital in a metropolitan city of eastern India. Materials and Methods: An observational qualitative study with cross-sectional design was conducted over 4 months in an immunization clinic of a medical college. With Ministry of Health and Family Welfare (MoHFW) prescribed checklist, session site was observed with non-participant stance, two vaccinators being public health nurses were interviewed and 35 caregivers of beneficiaries were interviewed at exit point. Results: Regarding session and logistics, adherence to NIS guidelines was observed mostly with few gaps in injection safety and hand washing practices. Except for one non-updated NIS schedule and one bio-medical waste management, no other IEC material could be noted at site. Only 28.6% of caregivers were found as aware of vaccines given to their children that day though importance of keeping mother-child protection card and noting of next vaccine date was among majority. AEFI knowledge was among 40% of caregivers and only 11.4% could say that “seven” visits up to 5 years of age are required for their children to get “completely immunized”. Conclusion: Despite commendable commitment and support from service side childhood vaccination is at stake which requires more advocacy, in-service training and supportive supervision
Assessment of proper use of Metered Dose Inhaler among patients attending the Out Patient Department of Respiratory Medicine: a cross sectional study
Full text linkIntroductionRespiratory inhalers are the backbone of asthma and COPDmanagement, targeting drug delivery directly to the airways(target zone).However, inhalers are very often used sub-optimally leading to uncontrolled symptoms and increased drugutilization for relief medication or preventative therapy, thereby increasing the prescription costs for patients.Objectives:Tofind out the socio demographic profile,disease characteristics, type of MDI used and assessing the correct stepsofusage of MDI among patients, attending Respiratory Medicine Outpatient Department of Nil Ratan Sircar Medical College,Kolkata.Materials and methods:An institutional based observational descriptive study with cross sectional design, was carried out, among 115 patientsusing MDI,>12 years attending respiratory OPD during the study period were included in the study. Data were collectedusing a predesigned and pretested schedule, entered into MS excel, cleaned and analysed with SPSS (IBM SPSS version20). Approval was taken from Institutional Ethics Committee.ResultsThe mean (standard deviation) age of the study population was 50 (14.5) years. Almost 53%(52.2%) of the patients wereusing steroid inhalers, 47.2 % of them for > 12 months. Most (93%) had been demonstrated by the treating physician. Only13% perceived difficulty in MDI use. The common mistakes made by the patients during MDI use were the following;13.9% sealed the mouth around the inhaler, 29.6% continued breathing after pressing the MDI and 38.3% rinsed theirmouth after using steroid inhaler.ConclusionsSeveral mistakes are committed by the users of MDI during the process, almost all of which can be minimized by repeatedinstructions and supervision of MDI technique by the treating physician. Proper MDI use will decrease drug wastageleading to better and cheaper management of symptoms.
Knowledge and perception regarding research among undergraduate medical students: a cross sectional study in Nilratan Sircar Medical college, Kolkata
Full text linkAbstract:
Background: Amendments in MBBS curriculum is increasing focus of research orientation of Indian Medical Graduates, still there is lack of research projects conducted by undergraduate students and a prominent deficit of evidence regarding their perception towards in research especially in west Bengal.
Aim/Objective: To describe the knowledge and perception regarding research and their socio-demographic correlates among Phase 1 and Phase 2 undergraduate students of NRS Medical College and Hospital, during the year 2023
Results: Majority of the students were aged between 20 and 21 years (49.3%), male (67%), Hindu (82%), from nuclear families (80.9%) and belonged to the upper class according to modified B.G. Prasad Scale (69.3%). Students have varying degree of knowledge regarding various steps of conducting research, research organisations across India, however, knowledge among phase I students was less than among phase II students. Median score regarding importance of research in academics and clinical practice was 8 (IQR:6-9) and for importance of involvement in research & motivation towards research was 7 (IQR:5-9). Median motivation score, reflective of the level of motivation, was only significantly different across sex, where females feel less motivated than males. As perceived by the study population, lack of adequate training come out as the biggest barrier in doing research.
Conclusion: Undergraduate medical students are motivated to conduct research but they are deficient in knowledge regarding the nuances of conducting the research mostly due to lack of time in their busy curriculum and lack of adequate training
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