International Journal of Medical Sciences and Education (IJMSE)
Vol. 7 Issue: 1 (Jan. - February 2020), Date of Publication: 01.03.2020

Table of Contents
     Editorial

1.      EFFECT OF ADJUSTMENT ABILITY ON ACADEMIC PERFORMANCE OF FIRST YEAR MBBS
         STUDENTS IN A GOVERNMENT MEDICAL COLLEGE IN SOUTH KERALA                                             1-7
         Dr. Gilsa. E.S, Dr. Miriam Varkey, Dr. Rajad. R, Dr. Alen Jude Thambi                                 PDF FULL TEXT

ABSTRACT

​Background: The adjustment problem is highly prevalent among medical students compared to other streams of education. Maladjustment has profound influence on the academic performances and also will also have many immediate and remote influence on the students both physical and mental health. Hence this study was undertaken to assess the adjustment ability of our students and its effect on their academic performances Methodology: Adjustment ability of 98 first year MBBS students in Government in Kerala Medical College was assessed using Bell’s adjustment Inventory (BAI). Scores obtained were compared with the marks scored for the final sessional examination using independent sample t Test Results: The mean Bells score for our students was 48.36± 14.17 which is above the cut off score of 44 indicating unsatisfactory adjustment ability. Out of 98 students 59 students were having Total Bell’s score above 44. There was no significant gender difference noted. There was a significant difference in the Bells score between the students who secured more than 50% marks and those who have not. Conclusion: This study shows that a majority of first year MBBS students in our institution have unsatisfactory adjustment ability. Adjustment issues should be of concern because they may lead to undesirable coping strategies like substance abuse and the incidence of this is found to be increasing in medical students in India as shown by many studies. Hence adjustment issues among students should be addressed effectively not only to improve academic performance, but to prevent psychiatric morbidities in the future
 Keywords-Adjustment ability, Academic Performance, Bell’s adjustment Inventory

2.     UNDERSTANDING ETYMOLOGY: AWARENESS AMONG DOCTORS AND A TOOL IN SUCCESSFUL
        MEDICAL EDUCATION                                                                                                                                  8-11
        David A Ebenezer, Saravanan Mohanraj                                                                                PDF FULL TEXT

ABSTRACT

​Background: The language of medicine has been derived from Latin and Greek, and so do many words used in the English language.  Knowledge of etymology will aid in better fixation of medical terms if connections are made between words used in English and medicine. For those medical terms that have no parallel in English, the introduction of the new term with etymology will create interest and make learning an enjoyable experience. Material & methods: In this cross-sectional study, 214 preclinical medical students were randomly separated into two groups. One group was taught osteology of skull with etymology while the control group was taught the same topic without etymology. After the session questionnaire and feedback forms were administered to the students and evaluated. To find out awareness about etymology among doctors a questionnaire was administered in which 44 doctors took part. Results: A strong correlation has been found to exist between teaching with etymology and performance in the evaluation immediately after the class. This group also rated the class to be fun and enjoyable, was able to better recall the terms, spell terms more accurately and was able to better understand the topic. The etymology awareness questionnaire for the doctors brought to light the very poor knowledge that most doctors have regarding medical etymology. Conclusion: This study recommends that medical faculty educate themselves on etymology and incorporate it into teaching for an intellectually satisfying class that will with the same stone etch the newly introduced terms in the minds of the student and result in successful learning.
Keywords: Medical Education, Medical Etymology, Medical Terminology, Teaching Faculty, Student Success

3.      ABSENTEEISM IN UNDERGRADUATE MEDICAL STUDENTS: A CROSS SECTIONAL STUDY         12-14
         Dr Pusapati Vaishnavi, Dr Siva Prabodh                                                                               PDF FULL TEXT

ABSTRACT

Background: Absenteeism is an important factor for decreased motivation in learning the subject. In literature it was found that absenteeism indicates low motivation for learning, poor teaching strategies, unfavorable environment, socialization, ill health and poor relations with lecturers. If this behavior continues after school, it will reflect on their work life and therefore, may affect the quality of health service in the future. This study is aimed at understanding the prevalence and underlying reasons for absenteeism. Methodology: This is a descriptive cross sectional study among second to final year students. A structured, pre tested questionnaire was developed with questions in themes of pattern and reasons for absenteeism was administered to a convenient sample of 100 students. Results: In this study, 47 hostlers and 53 day scholars were included in the sample for this study. Out of the 100 students, 84% said lectures are affecting their attendance which is statistically significant .Only 32% think attendance matters. 27% said that they are absent to study for exams. Conclusion:  Our study clearly shows the main reason for absenteeism is poor teaching practices. Socratic lectures replacing didactic ones should ensure mental attendance instead of just physical presence in class room.
Keywords:  absenteeism, attendance, Lectures, motivation, semester.

4.      INTRODUCTION OF IN SITU SIMULATION TRAINING FOR NEONATAL RESUSCITATION TO
         FINAL YEAR MBBS STUDENTS                                                                                                              15-22
         Pushwinder Kaur                                                                                                                    PDF FULL TEXT

ABSTRACT

​Background: Neonatal mortality occupies half of under-five mortality worldwide. Effective neonatal resuscitation at the time of birth accounts for declining neonatal mortality rate, learned through introduction of In situ simulation training to medical students, nurses and other paramedical staff at the early stage. Methods: A cross sectional study was conducted on 30 final year MBBS students during clinical posting in the Department of Pediatrics, Punjab Institute of Medical Sciences, Jalandhar in May, 2019. Students were exposed to In situ simulation training for neonatal resuscitation. Assessment of the students was done followed by feedback from students as well as faculty. Data collected was categorized as per Likert’s scale. Results: Students felt better perception of the topic and gained confidence after the hands on training. Students showed better motivation. In situ simulation generated interest in them to learn more regarding the neonatal resuscitation. Students identified the lacunae between knowledge and clinical skills. Teachers also identified the lacunae between student’s knowledge and clinical skills. Teachers identified the student’s areas of improvement. Conclusions: Introduction of In situ simulation for neonatal resuscitation among final year MBBS students results in remarkable improvement in clinical skills as well as better perception of the steps of neonatal resuscitation.
Keywords: In situ simulation, Neonatal resuscitation.

5.      STUDY OF PATTERN OF HEALTH PROBLEMS IN PADYATRIS OF AMBAJI PILGRIMAGE OF NORTH
         GUJARAT, INDIA                                                                                                                                        23-26
​         Dr. Amrapali Y. Patel, Dr. Vijay Pandya, Dr. Nirali Patel, Dr. Dhruv Y. Pate                        PDF FULL TEXT

ABSTRACT

​Background: We aimed to study the pattern of Health problems in Pilgrims on their journey to the holy temple of ShriArasuri Ambaji Mata Mandir, North Gujarat, India. Material and Methods: Nootan Medical College and Research Center, Visnagar had organised camp for padyatris. We have done secondary data analysis of record available of camps and catagorized the health problems of padyatris. Results: most common health problem in Pilgrim is Bodyache followed by Boils on foot, abdominal pain, weakness, Diarrohea etc. These yatris were given symptomatic treatment in form pain killers, antibiotics, analgesic sprays etc. Conclusion: This study was of short duration and limited to patients availed service from camp, it gives a good reflection of pattern of illnesses during Ambajiyatra.
Keywords: Health Problems, Pilgrims, Ambaji Pilgrimage

6.     VISUAL OUTCOME IN PATIENTS WITH INDIRECT TRAUMATIC OPTIC NEUROPATHY(TON) RECEIVING
        TIMELY INTERVENTION WITH METHYL PREDNISOLONE IN A TERTIARY CARE HOSPITAL OF
        SOUTHERN RAJASTHAN                                                                                                                         27-30
        Dr Nutan Bedi, Dr Saloni Patel                                                                                               PDF FULL TEXT

ABSTRACT

​Background: The incidence of traumatic optic neuropathy has shot up due to rapid increase in the number of vehicles on road. TON occurs in head or ocular trauma and endangers vision either due to direct or indirect injury to the optic nerve. Direct injury can be by sharp objects or displaced bony spicules. It may also result into optic nerve avulsion Material & Methods: The prospective study was conducted in 53 patients diagnosed with indirect TON who presented to the outpatient ophthalmology department of a tertiary care hospital in Southern Rajasthan. The study was undertaken in patients diagnosed with indirect TON and treated with methylprednisolone. Results: The pretreatment vision was ranging from 6/12 to 6/36 in 5 patients and 6/60 to CFCF in 14 patients. 34 cases had visual acuity between HM to NOPL. Total 36(67.92%) out of 53 patients had shown improvement in visual acuity after treatment in which patients who were given treatment with methylprednisolone within 24 hours(52.8%) of diagnosis had shown maximum improvement in vision followed by those in whom treatment was started within 72 hours(22.6%). Patients with delayed presentation between 1 week to 2 weeks had no improvement in vision, out of which ≥3 line improvement was found in 30 patients (60.3%). Conclusion: We concluded from the present study that our study emphasizes the use of high dose methylprednisolone for indirect TON to decrease the ocular morbidity to a considerable extent specially if the patients report within 24 to 72 hours.
Key words: Retinal degenerations, Retinal detachment, Lattice degeneration.

7.     COMPLETE DENTURE OBTURATOR PROSTHESIS WITH FUNCTIONAL SALIVA RESERVOIR        31-35
        Rachana Chaudhary, Dinesh Kumar, Anup Gopi, Dhruv Sharma                                       PDF FULL TEXT

ABSTRACT

Rehabilitation of maxillofacial defects is considered to be one of the most challenging treatment for a Prosthodontist. Rehabilitation of form, function and aesthetics is the prime objective of prosthodontic care. There are several methods for reconstruction of maxillectomy defects. Rehabilitation with obturator prosthesis is one of them. Obturator separates oral and nasal cavity and improves the phonetics, respiration, mastication, swallowing and overall improves the quality of life of the patient. Rehabilitation of completely edentulous patient is a challenge for prosthodontic rehabilitation and also adaptive capabilities of the patient. patients who are undergoing radiotherapy or underwent radiotherapy in past develops xerostomia, complete denture prosthesis are poorly tolerated in patients with xerostomia. A salivary reservoir can be incorporated into a denture which will provide continuous, slow, sustained release of salivary substitutes. This article describes the prosthodontic rehabilitation of a completely edentulous patient who was diagnosed with squamous cell carcinoma of hard palate. Secondary to radiotherapy patient developed xerostomia . to make the prosthesis comfortable patient was given a definitive complete denture obturator prosthesis with saliva reservoir . Quality of life of the patient was improved with properly designed obturator. The obturator restored patients mastication, swallowing, aesthetics, resonance and speech.
Keywords: Mastication, Prosthodontics, Speech, Quality of Life, Denture, Complete, Xerostomia, Carcinoma, Squamous Cell

8.      ASSESSMENT OF ACUTE RENAL OBSTRUCTION BY USING DOPPLER SONOGRAPHY                36-40
         Dr. Harish Chandra Chaturvedi                                                                                              PDF FULL TEXT

ABSTRACT

Background: Acute renal colic disease is among the commonest presentation observed in outpatient departments of urologic practice. Urolithiasis is among the most common cause of renal obstruction and seen frequently. Unilateral obstruction encountered more frequently than bilateral obstruction and resultant for maximum patient load, however bilateral obstruction presents with deteriorate renal functions but it is less common. Material & Methods: The present case-control, study patients who were presenting to the emergency department with unilateral acute renal colic from 24 hours of symptoms were enrolled for the study. The obstructed kidney was taken as a case kidney and the normal kidney was taken as the control. Results: The site of obstruction was proximal in 47% of patients and distal in 63% of patients. The mean RI of the obstructed kidneys which were proximally obstructed was (0.71±0.02) and the mean RI of the obstructed kidneys which were distally obstructed was (0.69±0.02). However, this difference was statistically non-significant. Out of total patients, 68 patients had a complete obstruction, while 32 patients had a partial obstruction. The mean RI values in completely obstructed kidneys were 0.73 ±0.02 and mean RI values in partially obstructed kidneys were 0.70±0.01. This difference was statistically significant; p<0.05. Conclusion: Doppler sonography has high sensitivity and specificity in the detection of acute unilateral renal obstruction and better diagnostic tools than conventional USG. The resistivity index values are significantly higher incomplete obstruction than partial obstruction. The resistivity index values were also higher in proximal obstruction than distal obstruction.
Keywords: Acute renal obstruction, Doppler sonography, Resistivity index.

9.     TO COMPARE THE EFFICACY OF  TOPICALLY ACETIC ACID IRRIGATION WITH  TOPICAL ANTIBIOTICS
        IN MEDICAL MANAGEMENT OF TUBOTYMPANIC CHRONIC SUPPRATIVEOTITS MEDIA (CSOM)     41-50
        Dr. Vipasha Yogi, Dr. Pratibha Vyas, Dr. Bhargavi Trivedi, Dr. Biban Chhabra                     PDF FULL TEXT

ABSTRACT

Background: Chronic suppurative otitis media (C.S.O.M.) is a disease of multiple etiology and is well-known for its persistence and recurrence inspire of treatment. Nowadays, because of the excessive and unconventional use of broad-spectrum antibiotics, corticosteroids, and cytotoxic chemotherapy, the resistance emergence has increased in recent years. Due to the cost of long term treatment is an important factor in developing countries. It has become a difficult task to treat for ENT specialists. Acetic acid alters the pH of EAC and the middle ear to treat otorrhea in CSOM that needs to be studied. Methods: 200 patients with active CSOM were randomly distributed in two groups. One hundred patients in each acetic acid and topical antibiotic group. Acetic acid and topical antibiotic irrigation were done for 3months in each group. Pus culture and sensitivity was done for each patient. Both groups were followed up for three months and observed for resolution of ear discharge and healed perforation. Results: In our study, otorrhea resolution with acetic acid was 92%and of the topical antibiotic group. 88% of patients had successful otorrhea resolution. The mean time of otorrhea resolution was 30.4 days in a topical antibiotic group, whereas 30.9 days in acetic acid group. No statistically significant difference between both the groups in otorrhea resolution was seen in active CSOM (p >0.05). Conclusions: Inactive CSO Macetic acid can be used as an alternative treatment method, which is cost-effective and easily available and performed even at a primary health center for the resolution of ear discharge in active CSOM. As long term management of chronic ear discharge may be required in CSOM.
Keywords: Chronic Suppurative Otitis media, Acetic acid,

10.    COMPARATIVE STUDY BETWEEN IMMEDIATE SURGICAL AND CONSERVATIVE MANAGEMENT OF
         APPENDICULAR LUMP                                                                                                                            51-53
         Dr. Hukam Chand Meena, Dr. Chandra Mauli Vyas, Dr. B.C. Mewara                                PDF FULL TEXT

ABSTRACT

Background: In the present scenario acute appendicitis is the most common cause of acute surgical abdomen. The operative procedure of choice is appendicectomy for non- complicated appendicitis. Delayed case scenario of appendicitis cause lump formation reported among previous studies. The long-established treatment for an appendicular lump that is a conservative treatment followed by interval appendicectomy still a very popular procedure among surgeons. Methods: In the present retrospective study, we enrolled 40 patients who had an appendicular lump and randomly divided them among two groups, Group 1 included patients with conservative treatment which followed by interval appendicectomy after 6-8 weeks and group 2 included patients with immediate surgery. Results: In the present retrospective study, we found that the highest incidence of the appendicular lump was reported among the age group of 21-30 years. The average duration of hospital stay was 11 days in groups 1 and 5 days among patients of group 2. In the present study, we found immediate surgery was a better management plan for appendicular lump which result in lesser duration of hospital stay, lesser economic burden, no chances of readmission to the hospital and no reported major complication during follow-up. Conclusions: Early exploration for appendicular lump is a preferred option rather than conservative treatment followed by interval appendicectomy.
Keywords: Appendicitis, Appendicular lump, Management