International Journal of Medical Science Research and Practice (IJMSRP)
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TB contacts in family and high positive smear: Is there a need of sputum culture at the earliest?
No full textAim- To assess the role of TB contacts at various places in severity of PTB.
Background- Tremendous progress has been made in combating TB over the past ten years. But, dramatic changes in TB epidemiology are challenging TB control activities.
Material Methods- An observational study at DOTS centers in E ward of Mumbai Municipal Corporation was carried out during 1st January 2004 to 30th June 2004. A Pre-tested structured interview schedules were fulfilled by interviewing new smear positive pulmonary tuberculosis patients registered during study period. Data regarding sputum smear examination report at the beginning & at the end of intensive phase were collected from respective DOTS centre.
Results- 156 patients were interviewed with 67.3% males & 32.7% females. 24.2% were illiterate, 43.3% were unemployed, 52% belonged to socio-economic class IV & V, 53.8% were migrants.52.6% had history of known TB contact. High positive sputum smear was associated with history of known TB contact in family (p= 0.03, OR= 1.773, 95%CI= 1.102- 3.094). Patients with high sputum smear positivity were more likely to show sputum smear non-conversion at the end of intensive phase (OR= 2.347, 95% CI= 0.953- 5.782)..
Conclusion- Contacts in family play important role in causation of severe TB disease & consequently sputum non-conversion which is a risk factor for MDR-TB. Physicians or facilities can take decision about investigations like sputum culture and sensitivity at the earliest for such patients
Meropenem: Current perspective
No full textoai:ojs.pkp.sfu.ca:article/1Meropenem is an ultra broad spectrum parenteral carbapenem with excellent safety profile and minimal drug interactions. It is effective in a variety of tissue infections. But to prevent emerging drug resistance, its use should be restricted to complicated/serious infections not amenable to other antimicrobials
Problem Based Learning: What and Why
No full textThe goal of Medical Education is to produce qualified Physician. Though we are using different method to train undergraduate students, but Problem based learning (PBL) is an innovative teaching learning method that impart knowledge, enhance intrinsic motivation , promote self learning, encourage clinical reasoning and also encourage them to work in a team. Activation of prior knowledge, encoding specificity and elaboration of knowledge are three principles of acquiring new information. These principles have been included in to the seven jump theory. In conclusion, the PBL is student centered self motivational, active and a challenging method of teaching and learning both for faculties as well as students
Incidence of placenta previa in cesarean section
No full textAim-To study the incidence of placenta previa in previous cesarean section and compare it with incidence of placenta previa in women with no prior cesarean section.
Background- There is an evident literature support which suggest that the chances of placenta previa are not only more in patients who had a previous history of cesarean section but the chances also increases with the number of cesarean section in past. The overall incidence of placenta previa is 0.2-0.5% in western studies. It may be more in Indian population. As there were not many studies on this important topic from Indian subcontinent.
Material Methods-Total 484 patients with history of previous Lower Segment cesarean Section were selected for study purpose. 496 subjects with no previous history of cesarean section were selected for control purpose. Clinical examination and USG was done at 28 weeks to detect placenta previa.
Results-Ten cases of placenta previa were found in the study group and incidence of placenta previa was calculated to be 2% in this group compared to incidence of only 0.6% i.e. 3 cases in control group (p< 0.05). Also the chances of finding placenta being morbidly adherent were increased in the study group as we found 2 cases of placenta increta and 3 cases of placenta accreta among these.
Conclusion-Incidence of placenta previa is high in patients with previous cesarean section as well as chances further increases with the successive increase in number of cesarean section in past
Cystic Hygroma in a Newborn
No full textA newborn presented with cystic hygroma in axilla. In view of rarity of condition, presentation at birth at unusual site and classical features of clinical condition, we are reporting the case
Evaluation of Lung Function by Spirometry in 12-14 yrs Adolescents in schools of Raipur city Chhattisgarh
No full textAim- The study was carried out in normal school children in Raipur city to determine pulmonary functions in the age group 12-14 years.Background- Spirometry is a important tool to assessment of lung function by evaluating forced vital capacity (FVC), forced expiratory volume in first second (FEV1), the ratio of FEV1 to FVC, peak expiratory flow rate (PEFR). Indian norms for spirometric test values are different from Western and other norms. Even within the country the test values differ between different regional and ethnic groups.Material Methods- This is Cross sectional analytical observational study. 267 subjects were evaluated through pulmonary function test by Spirometry. Results were expressed as Mean ± SEM (Standard error of mean). Pearson’s correlation coefficient(r) is calculated between dependent and independent variables. Prediction equations were developed using the multiple linear regression procedure.Results- In our study spirometric parameters for boys were higher than girls. All Spirometric values were found to increase in relation to increase in height in both girls and boys except for the FEV1 %. All Spirometric values were found to increase in relation to increase in Age (12 to 14 years) in both girls and boys except for the FEV1 %.Conclusion- This study shows, all the independent variables (age, weight, height and BSA) have linear positive correlation with lung function parameters, both for boys and girls. Height is the most important and reliable single independent variable. Regression equations for spirometry variables for region have been developed
Outbreak of Ebola virus click alarm for devastating epidemic
No full textEbola viral disease formerly known as ebola hemorrhagic fever is a severe, often fatal illness in human, outbreaks having case fatality rate upto 90%.It was first noted in 1976 , and is a WHO risk group 4 pathogen, many outbreaks have occurred since then but 2014 outbreak is worst outbreak in terms of cases and fatalities. Unfortunately the infecting Ebola virus detected this outbreak is Zaire strain, the most pathogenic strain of Ebola. Health agencies are forced to term this outbreak as an "unprecedented epidemic" seeing its devastating impact
Mobile phone surveillance and relationship between quantitative cultures and type of mobile device: A pilot study
No full textAim-In this study an attempt was made to compare the mobile phone microbiota from health care workers among various departments and individuals from community not exposed to health care and correlate the quantum of bacterial load with the type of mobile phone.Background-Inanimate object like mobile phones in the hospital environment are contaminated and are known to be considered as sources of Hospital Care Associated Infection (HCAI). It is also important to know the bacterial load on mobile phones and knowledge regarding mobile phone as source of nosocomial infection among health care workers (HCW) compared to people from community.Material Methods-Study population and size included 100 healthcare workers from various departments of a tertiary care hospital and 50 individuals from a middle class community of East Delhi. Self structured questionnaire were distributed among the study population and quantitative culture from mobile phones were done.Results-Total thirtee six of 100 mobile hand sets of health care workers (HCW) were colonized of which 6 were polymicrobial colonisation with average bacterial load of 2709. In the community based survey, 19 (38%) of the mobile handsets were colonized having average bacterial load of 2490 CFU per handset.Conclusion-Mobile phones used by HCWs in daily practice may be a source of nosocomial infections in hospitals. There is a threat of spreading infection by mobile phone if not disinfected properly. This is similar to the importance of hand hygiene in preventing spread of infection. If use of mobile phones is imperative, then strict mobile friendly disinfection policies need to be formulated and implemented
Urgent carotid endarterectomy for acute cerebral ischemia
No full textBackground-Carotid endarterectomy (CEA) is well established as the elective treatment for severe symptomatic carotid stenosis . In contrast, the merits of CEA performed as an emergency procedure in patients with acute stroke or fluctuating neurological deficit remain controversial.Material Methods-CEA was performed as an emergency procedure on 16 patients within 4 to 48 hours after the onset of symptoms. Patients selected for urgent surgery fulfilled the following criteria: acute onset of fluctuating hemispheric neurological symptoms, significant carotid pathology, absence of cerebral hemorrhage, absence of massive cerebral damage and stable cardiopulmonary conditions. The patients presented with a crescendo-TIA in 7, evolving (stuttering) stroke in 3 and fluctuating neurological deficits in 6 - corresponding to a contralateral carotid stenosis.Results-Following CEA, the neurological deficits improved instantaneously to complete recovery in 10 patients. The symptoms of 4 patients improved to non-disabling deficits, and remained unchanged in two patients. 14/16 patients were discharged within 8 days after admission. The neurologic status after discharge did not deteriorate in any of the patients during follow up - in fact it further improved in 4 of the patients (2 in whom there had been no change and 2 in whom there had been a partial improvement).Conclusion-Emergency CEA may be beneficial for selected patients with stroke in evolution and fluctuating neurological deficits. Careful adherence to selection criteria, judicious intraoperative shunting, intensive unit care post surgery and an experienced team are recommended
Mobile Phone SMS-Based Educational Intervention To Medical Undergraduates For Reduction of Stigma and Discrimination Against PLHIV In Healthcare Settings
No full textAim- To provide mLearning intervention to experimental group of 30 medical students using mobile phone based SMS technology
Background- Medical students universally own mobile phones with a potential to meet their educational needs. mLearning is a type of mHealth for educating and increasing the capacity of health care providers.
Material Methods- A pre-test and post-test, cross-sectional study design was used to assess the levels of knowledge, attitudes of 30 clinical undergraduates regarding stigma and discrimination towards People Living with HIV (PLHIV) in healthcare settings during August to October 2013 in Tagore Medical College Hospital, Chennai. The intervention phase included the design and implementation of mLearning initiative through SMS technology.
Results- Fears of contagion (33%) and poor awareness (23%) among care providers were identified as reasons for stigma. Improved knowledge about definition of stigma 100%, 97% for Quality, Quantity of HIV virus and Route of transmission (QQR) determining the risk of HIV transmission, 97% for identifying scheduling consultancies towards the end and charging high for PLHIV surgeries as stigma, is seen in experimental group.
Conclusion- mLearning opportunities support stigma reduction in health care settings by improving knowledge and attitudes of care providers