International Journal of Medical Sciences and Education (IJMSE)
Vol. 8 Issue: 2 (April-June 2021),  Date of Publication: 01.07.2021

1.    STUDY OF STUDENT’S FEEDBACK ON THE SKILL MODULE IN FOUNDATION COURSE IN FIRST YEAR             MBBS CURRICULUM                                                                                                                                  1-6                 Ambade Hemlata Vipul, Nemade Kirti , Kamdi Namdeo                                                          PDF FULL TEXT

ABSTRACT

Background: The Medical Council of India new competency based medical education (CBME) for medical graduates is a major landmark for medical education in India. As per the new curriculum, one month foundation course has been introduced at the entry level of medical (MBBS) students so as to acclimatize the new environment of the medical colleges. Material and methods: At the end of foundation course, study was carried out to evaluate the student perception regarding utility of skill module. A predesigned feedback forms related to questionnaire based on skill module were distributed to the first year MBBS students participated in the foundation course and the results were analyzed. Results: More than 95% positive feedback was recorded in relation to objectives, contents, presentation and future value of the skill module in foundation course as per new CBME curriculum. The present study also discusses the views of the students about skill module and also the problems faced by them while learning skill module in the foundation course at the beginning of their carrier. Conclusions: Skill module is the best part of foundation course. It helps the new medical aspirants to adapt the environment at new medical institution and to acquire the basic skills necessary for their future journey of education and medical practice.
Keywords: CBME curriculum, MCI, Foundation course, Skill module, medical graduates

2.    STUDENT’S PERCEPTION OF OBJECTIVE STRUCTURED PRACTICAL EXAMINATION (OSPE) AS AN                  ASSESSMENT TOOL                                                                                                                                7-10                 Dr.S.Vishnuprasaath, Dr. Karthika. M,  Dr. Sajuni I, Dr.Sangeetha. A,  Dr.Vijayalakshmi B  PDF FULL TEXT

ABSTRACT

Background: Education and verification of results are interrelated. The verification of such learning outcomes not only verifies the knowledge but also project-specific skills. The Conventional practical exam is beset with many problems. Hence the need for some innovation is required.  Objective: The present study was conducted to evaluate the implementation of OSCE, a new method of assessment for medical students by student feedback. Material & Methods: A Observational Study including 50 first year M.B.B.S. Students were conducted in the Department of Physiology in ESIC Medical College& PGIMSR, K.K.Nagar, Chennai. Topics from Respiratory Physiology were chosen for OSPE. On the day of OSPE 3 stations were arranged and three minutes were allotted for each station. Data about the feedback of OSPE was collected from participants using a validated and structured Questionnaire. Results: The study shows that OSCE is an effective tool and can be used to test the knowledge, skills, and attitude of the medical student by enhancing objectivity in the assessment.
Keywords: OSPE, assessment tool, knowledge, skills, and attitude

3.    COMPARISON OF TRANSCUTANEOUS BILIRUBIN AND TOTAL SERUM BILIRUBIN MEASUREMENTS IN             JAUNDICED PRETERM NEONATES                                                                                                        11-16
 
       Dr. Sourabh Singh, Dr. Nikita Gupta                                                                                        PDF FULL TEXT

ABSTRACT

Background: Jaundice is the most common morbidity in the first week of life occurring in 60% of term and 80% of preterm newborns & it is the commonest cause of readmission after discharge from birth hospitalization. (1,2) An accurate noninvasive measure of transcutaneous bilirubin (TCB) would be helpful because it would decrease blood sampling for a frequent and usually benign clinical condition. Currently, transcutaneous bilirubin is recommended above 35 weeks of gestation. Method: We planned this study, to compare transcutaneous bilirubin and total serum bilirubin in jaundiced premature neonates according to gestational age (28-32 weeks v/s 32-37 weeks) before phototherapy. Result: In our study, we established a comparison of transcutaneous bilirubin and Total serum bilirubin measurements in preterm neonates 28 to 37 weeks of gestation before phototherapy. This study has demonstrated the reliability of TCB measurements in small preterm infants even before phototherapy. The mean difference between TCB and TSB was approximately 0.88mg%. Gestational age, comorbidities and risk factors for jaundice did not influence the correlation. Conclusion: TCB is an easy rapid non-invasive procedure that prevents pain, hematoma, risk of infections and decreases repeated drawing of blood.
Keywords: Neonatal jaundice, transcutaneous bilirubin, preterm

4.    A REVIEW OF VERTICAL CONTROL IN FIXED ORTHODONTICS                                                         17-23
 
       Dr. Garima Goyal, Dr. Ashish Gupta, Dr. Anushree Agrawal, Dr. Prateek Agarwal             PDF FULL TEXT

ABSTRACT

In previous studies, various terms are described to define the excessive vertical facial height, dolichofacial pattern, including hyperdivergency and leptoprosopic pattern. The adequate control of the vertical dimension is reported to be essential for a successful anteroposterior correction. Extreme dextrorotation, high angle type, hyperdivergency, dolichofacial pattern, adenoid faces, idiopathic long face, total maxillary alveolar hyperplasia, and vertical maxillary excess all have excessive vertical growth of the maxilla as their common denominator. Thus, it had been very difficult to differentiate this vertical maxillary dysplasia is categorized as a traditional anteroposterior classification. Maxillary molars are stated to be the first ‘bite openers’ and mandibular incisors, are stated to be the first ‘bite closers’. An increase within the vertical facial dimension results in more vertical displacement and that leads to rotation of the maxilla and mandible, which often results in prolonged treatment times, poor esthetic results, and compromised treatment objectives.
Keywords: vertical control, orthodontics, vertical maxillary dysplasia.

5.    SERIES OF COVID-19 PATIENTS WITH A SIGNIFICANT SPONTANEOUS PNEUMOMEDIASTINUM AND                 SPONTANEOUS SURGICAL EMPHYSEMA                                                                                            24-30
 
       Dr Noof Ibrahim Ali Al-balushi, Dr Adil Sulaiman Al- Kharusi, Dr Nilay Chatterjee, Dr Sanjay Gulani
       Dr Samaresh Das, Dr Sharoz Rayhan                                                                                     PDF FULL TEXT

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic presents mainly with respiratory symptoms and signs. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first detected in Wuhan, China, in December 2019. In a recent series of patients with severe acute respiratory syndrome secondary to corona virus pneumonia, pneumomediastinum (SP) and spontaneous surgical emphysema (SSE) have been reported. A clear mechanism by which SP and SSE occur in SARS-CoV-2 pneumonia is unknown. However, SP and SSE are in principle considered self-limiting conditions that respond to conservative therapeutic measures. The progress of these conditions should be monitored for the possibility of pneumomediastinum-related cardiovascular and respiratory complications.
Keywords: COVID-19; pneumothorax; pneumomediastinum

6.   ASSESSMENT OF CARDIAC AUTONOMIC DYSFUNCTION AMONG PATIENTS WITH DIABETES MELLITUS         AND ITS ASSOCIATED FACTORS                                                                                                            31-35
 
      Dr Dheerendra Kuber, Himanshu Mathur, Anshumali Singh                                                 PDF FULL TEXT

ABSTRACT

Background: Autonomic neuropathy was only generally recognized as part of the spectrum of nerve damage in diabetes. Autonomic neuropathy is the ‘needle in the haystack’ in the complete evaluation of a diabetic patient. Most clinicians tend to neglect these symptoms even though their patients present only with them. Material & methods: the present prospective study including 100 diabetic patients which were selected by simple random sampling. Strict confidentiality was maintained with patient identity and data and not revealed, at any point of time. Results: Majority 17% of patients had early cardiac autonomic dysfunction, followed by 7% patients had definite, 3% patients had atypical and severe cardiac autonomic dysfunction respectively. Mean age in cases with autonomic dysfunction was 46.25 (S.D.±6.24) and 38.42 (S.D.±7.38) with no autonomic dysfunction. Z value worked out to be 3.38 which is statistically significant (p<0.05). Mean duration of diabetes in cases with autonomic dysfunction was 6.83 (S.D.± 2.01) and 5.24 (S.D.± 2.48) with no autonomic dysfunction. Z value worked out to be 2.43 which is statistically significant (p<0.05). Mean BMI in cases with autonomic dysfunction was 27.61 (S.D.±2.53) and 24.16 (S.D.±2.90) with no autonomic dysfunction. Z value worked out to be 3.52 which is statistically highly significant (p<0.05). Among 52 cases with >7 HbA1c, 22 had autonomic dysfunction and 30 cases did not have autonomic dysfunction. Among 48 cases with ≤7 HbA1c, 8 had autonomic dysfunction and 40 did not have autonomic dysfunction, which is statistically significant (p<0.05). Conclusion: We concluded from this study that incidence of cardiac autonomic dysfunction among patients of Diabetes Mellitus was more prevalent in age group 40 to 50 years. Other associated factors were high body mass index, increased duration of diabetes and raised HbA1c value for occurrence of cardiac Autonomic dysfunction secondary to Diabetes Mellitus.
Keywords: Diabetes, Autonomic Dysfunction, HbA1c.

7.   ASSESSMENT OF FREQUENCY OF CATHETER-RELATED BLOOD STREAM INFECTIONS AT PEDIATRIC            SURGERY INTENSIVE CARE UNIT OF TERTIARY CARE CENTER                                                      36-39
 
      Dr. Praveen Jhanwar, Dr. Hanuwant Singh                                                                               PDF FULL TEXT

ABSTRACT

Background: Catheter-related bloodstream infections are associated with an approximate mortality rate of 12% to 25%. Studies reported that some pathogens can form biofilm and colonize central venous catheters. These colonizations are reported as a major cause of catheter-related infections and bacteremia among patients. Material & Methods: The present cross-sectional observational study was conducted at the Department of Pediatric Surgery of our tertiary care Hospital. The study was an observational study conducted over two years. The study was done at 95% confidence interval at 10% of maximum allowable error. The sample size of 100 patients was calculated by epi info software. Clearance from the hospital ethics committee was taken before the start of the study. Written informed consent was taken from each study participant. Results:  In the present study we enrolled a total of 100 Patients who had clinical signs and symptoms of bacteremia and septicemia and were suspected of catheter-related blood stream infection due to indwelling central venous catheters were selected among patients admitted in Pediatric Surgery Intensive Care Unit. Out of the total study participants, it was found that 54% of study participants had CVC tip colonization which was followed by Central line-associated bloodstream infections which were present in 12% of patients. Catheter-related bloodstream infections were positive among  4% of patients and catheter-related candidemia was present among  3% of study participants. Conclusion:  We concluded from the present study that Candida species were the most common important cause of catheter-related bloodstream infection among patients from Pediatric surgery intensive care units.
Keywords: catheter-related blood stream infection, bacteremia, septicemia.

8.   COMPARATIVE EVALUATION OF THE EFFECTS OF SILODOSIN AND TADALAFIL IN PATIENTS OF                       BENIGN PROSTATE HYPERPLASIA WITH LOWER URINARY TRACT SYMPTOMS                         40-44

       Dr. Hanuwant Singh , Dr. Kshitiz Ranka                                                                                  PDF FULL TEXT

ABSTRACT

Background: Silodosin is a highly selective alpha-1A receptor antagonist with little or no cardiovascular adverse effects. Previous immunohistochemical researches indicate that PDE5 is localized on the endothelial and smooth muscle cells of the lower urinary tract blood vessels. Various studies reported that PDE5- inhibitors can relax isolated prostate and bladder neck strips. Material & Methods: The present prospective observational study was conducted at the Department of surgery at our tertiary care hospital. The study duration was June 2018 to May 2019. A sample size of 150 was calculated at a 90 % confidence interval at a 5 % acceptable margin of error. Clearance from Institutional Ethics Committee was taken before the start of the study. Written informed consent was taken from each study participant. Results: In the silodosin group PVR improve from 63.6 ml (average) to 32.8 ml (48.42% improvement) while in the tadalafil group PVR dropped from an average of 54.2 ml to 27.9 ml (i.e. 48.53% improvement). In the silodosin group Qmax at the time of presentation was 12.9 and at 4th and 12th week was 15.4 and 17.3 respectively (25.4% improvement). Qmax in PDE5 I group improves from 13.0 to 15.6 in the 4th week and further to 17.4 in the 12th week (26% improvement). In the silodosin group, IPSS was 18.6 at the time of presentation which also improves to 14.8 and 12.8 at 1 and 3 months respectively. Thus 31.2% improvement was seen in the silodosin group. In the tadalafil group, the IPSS at the time presentation was 16.2 which improves further to 12.6 and 10.9 at 1 and 3 months respectively. Overall, 35.2% improvement was seen in the tadalafil group. In terms of p-value, there was a significant improvement in intragroup comparison at initial, 1 month, and 3 months assessment (p-value <0.05), But when compared with both groups, the improvement was not statistically significant (p-value >0.05). Conclusion: We concluded from the present study that the outcome of the individual drugs was compared with each other and no statistically significant advantage was observed in terms of outcome.
Keywords: BPH, IPSS, Qmax.