International Journal of Medical Sciences and Education (IJMSE)
Vol. 7 Issue: 4 (July-Aug. 2020), Date of Publication: 01.09.2020

Table of Contents
     Editorial

1.    CRITICAL LOOK AT CHALLENGES IN THE MEDICAL LABORATORY SCIENCE TRAINING IN THE
       WORKPLACE                                                                                                                                                  1-4
       Dr. Reza Mortazavi                                                                                                                    PDF FULL TEXT

2.    THE IMPORTANCE OF IMPLEMENTING AUTHENTIC TEACHING AND LEARNING TECHNIQUES IN
       MEDICAL SCHOOL                                                                                                                                         5-9
       Ibrahim Kamil Luttfi                                                                                                                  PDF FULL TEXT

ABSTRACT

Authentic learning is the actual life learning. It is a style of learning that promote the students to create a valuable product. Authentic learning concentrate on real-world, complex problems and their solutions. The teacher becomes a guide on the side as a facilitator. Authentic learning catches all the senses allowing students to make a significative, favorable, and shared outcome. The importance of authentic teaching and learning include Students are more likely to be interested in what they are learning, students are better prepared to succeed in college, careers, and adulthood, Meet the students’ learning needs, Stimulate personal motivation, Assure the much needed mental comfort and confidence, Encourage learners to assimilate and connect knowledge that is unfamiliar, Enhance transferability and application of theoretical knowledge to the real world and Students practice higher-order thinking skills. The outcome of any education system should be to send students into the world prepared for both their personal and professional lives. Education and life should not be isolated from each other. What we can do is teach our students to be adaptable and creative thinkers who are able to utilize the skills and knowledge they do have to create new solutions to problems. By giving students the opportunity to learn through authentic, real-life, relevant learning experiences, we are giving them the ability to apply their learning, to learn through doing, to see their abilities, to adapt and change, and to form the habits required to do this successfully in their lives beyond medical school.
Keyword: Authentic learning, Clinical Teaching, Team- Based Learning, Problem-based Learning

3.    PERCEPTIONS AND PRACTICES REGARDING CLINICAL ETHICS BY POSTGRADUATE MEDICAL
       STUDENTS IN A TERTIARY CARE HOSPITAL IN LUCKNOW                                                                 10-17
       Anila Varghese, Monika Agarwal                                                                                             PDF FULL TEXT

ABSTRACT

Background: Postgraduate medical students face many issues regarding clinical ethics. Inadequate management of ethical issues in patient care can lead to multiple conflicts. This study was conducted to explore the perceptions and practices regarding standard clinical ethics and the challenges faced by postgraduate residents. Methods: A Cross- sectional, facility-based study was conducted among 145 postgraduate medical students in King George’s Medical University using a pre-tested semi-structured questionnaire. Results: 64.1% residents face ethical problems daily during clinical practice. The most common challenge faced by them is lack of clear guidelines. Only 8.3% had received training in Clinical ethics. Majority of the participants felt a need for further training in dealing with issues of clinical ethics before completion of post-graduation. Conclusion: Postgraduate residents experience ethical Issues frequently at work, but lack the training to resolve these dilemmas. The incorporation of a bioethics curriculum in the post-graduation programmes would be beneficial.
KEYWORDS: Clinical ethics, Postgraduate medical education, Bioethics

4.    THE ASSESSMENT OF FUNCTIONAL OUTCOME OF CONSERVATIVE MANAGEMENT OF ACETABULAR
       FRACTURES AT TERTIARY CARE HOSPITAL                                                                                          18-22
       Jay Satish Bhatt,  Naveen Rathor                                                                                            PDF FULL TEXT

ABSTRACT

Background: Acetabular fractures are the consequence of high-speed injury including 18% of all pelvic fractures. Anatomical and compatible decrease of the acetabular break is the best quality level in the administration of the acetabular cracks. In the distributed writing both moderate and employable administrations have been examined having points of interest and hindrances of both the modalities of treatment. Material & Methods: The present retrospective study was conducted at the Department of orthopedics at our tertiary care hospital. The study group of 50 patients, consisted of mainly patients from different parts of Rajasthan and also some from the states like Gujarat and Madhya Pradesh. Results: The study included 50 patients with the average age of 42.7 years with 32 patients (64 %) male and 18 patients (36%) female patients with the average BMI 26.1 kg/m2. The mechanism of injury was commonly RTA in 37 (74%) of patients and 13 (26%) fell from a height. Based on the X-rays and CT scan patients had fractures involving 16 (32%) posterior wall 4 (8%) posterior column, 5 (10%) anterior column, 4 (8 %) transverse, 2 (4%) posterior column with posterior wall, 5 (10%) transverse with posterior wall, 4 (8 %) T-shaped, 1 (2%) anterior column with posterior Hemi-transverse, and 9 (18%) involved bi-columnar fractures. The average duration of skeletal traction was 5.8 weeks and the average follow up was 5.7 years with the minimum follow up of 3 years and a maximum of 8 years. Functional outcome score showed good to excellent results in 82%, fair to satisfactory results in 14-16%, 2-4% had a poor result in the patient analyzed with both Harris Hip Score, Merle d’Aubigne, and Postel score. 41 (82%) patients were able to sit cross-legged, 46 (92%) had returned to regular work and 4 (8%) patients changed their occupation to desk jobs. Conclusion: Acetabular fractures can be dealt with minimalistically with great to magnificent outcomes. Joint congruency must be kept up particularly in a weight-bearing arch and checked with sequential x beams during the treatment with a foothold and early scope of development of the hip joint, proprioceptive exercise, muscle reinforcing with reformist stride preparing will give great to fantastic Functional and clinical result.
Keyword: Acetabular fractures, Functional outcome, Conservative.

5.    ASSESSMENT OF THE CLINICAL PROFILE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
       AMONG NON-SMOKERS AT TERTIARY CARE CENTRE                                                                          23-27
       Dr. Manish Kumar Jain, Dr. Nalin Joshi                                                                                  PDF FULL TEXT

ABSTRACT

​Background: Chronic pulmonary obstructive disease (COPD) has been liable for the diminished quality of life just as expanded grimness and mortality. All-inclusive it has been assessed that about 3,000,000 people worldwide died because of  COPD and bound to possess the third spot of mortality by 2030. It has been additionally assessed that in India the prevalence of COPD is approximately around 30 million. Material & Methods: The present prospective study was conducted at department of respiratory medicine of our tertiary care hospital. In present study, we enrolled 50 study participants from outdoor and from ward by simple random sampling, who were presented with signs and symptoms of chronic obstructive pulmonary disease. Clearance from Institutional Ethics Committee was taken before start of study. Written informed consent was taken from each study participant. Results: On the basis of the Systemic examination finding, the most common finding was rhonchi among 96% patients which was followed by hyper resonance among 32% patients followed by obliterated liver dullness, obliterated cardiac dullness and crepitation among 28% patients respectively. 26% patients had loud p2 sound which was followed by reduced chest movements and Reduced Crico-sternal distance among 24% patients respectively. 18% patients had barrel chest which was followed by finding of accessory muscles among 12% patients. Reduced air entry seen in 8% patients and 4% patients had Intercostal chest retractions. On the basis of the symptoms all study participants had complain and symptom of dyspnoea. Out of the total, 92% patients had cough which was followed by expectoration in 56% patients which was followed by wheeze in 28% patients which was followed by fever among 10% patients. Conclusion: We concluded from the present study that introduction of COPD stay same in non-smokers which incorporates Dyspnea, Rhonchi and cough. Basic hazard factors for non-smoker COPD are Indoor Air Pollution, Cotton Mill laborers and low Socioeconomic class. Among indoor contamination, LPG, lamp fuel and wood/coal burning fumes are the hazard factors for non-smokers COPD in non-smokers.
Keywords: COPD, clinical profile, risk factors.

6.    SEROPOSITIVITY OF TRANSFUSION TRANSMITTED INFECTIONS IN BLOOD DONORS IN BLOOD
       BANK, TERTIARY CARE CENTRE OF PEDIATRIC INSTITUTE SPMCH HOSPITAL, JAIPUR                28-34
       Dr. Saroj Pachori, Dr. Parmendra Pachori, Dr. Durgesh Tiwari, Dr. Neelima Purohit           PDF FULL TEXT

ABSTRACT

ABSTRACT                               
Introduction: Transfusion transmitted infections can cause major risk to safe blood transfusion can cause acute or delayed complications including HIV, hepatitis B and C, syphilis, malaria etc. hence, to prevent transmission of these disease screening tests on blood bags is an important step for blood safety. Objective: To Study the Seroprevalence of Transfusion Transmitted infections in healthy blood donors in blood bank, tertiary care centre of pediatric institute SPMCH hospital, Jaipur. METHODS: This retrospective study was carried out in blood donors in blood bank over a period of 14 months from August-2018 to September 2019. Serum samples were screened for hepatitis b surface antigen (HBsAg), Antibodies to Human immunodeficiency virus (HIV I & II), HCV, syphilis and malaria. Results: A total of 6540 healthy donors were included in the study. The overall seroprevalence was 122 (1.87%). Out of which HIV was 7 (0.107%), HBsAg was 80 (1.22%), HCV was 9 (0.137%), VDRL was 26 (0.40%) and malaria was 0 (0%). Conclusion: Methods to ensure a safe blood supply should be encouraged. For that, stringent donor selection criteria and NAT technology should be implemented.
Keywords: Hepatitis B Surface Antigen, hepatitis C virus, human immunodeficiency virus, seroprevalence, transfusion transmitted infections.

7.    RISK FACTORS FOR ANEMIA IN PREGNANCY: A CASE CONTROL STUDY                                        35-38
       Dr. Neeru Sharma                                                                                                                       PDF FULL TEXT

ABSTRACT

Aim of the study was once to locate the threat elements main to Anemia in pregnancy. The foremost goal used to be to find out about a variety of sociodemographic elements main to anemia and to verify the understanding about anemia amongst find out about participants. The present Case-control study was carried out at Primary Health Centre, to decide the danger elements main to anemia in pregnancy. A whole of 308 pregnant women have been registered. Among them two companies have been made, the team I instances and crew II controls. Each crew had 50 instances each. Laboratory take a look at had been finished and women having hemoglobin much less than 11mg/dl had been viewed anemic. Anemic women have been viewed instances and girls having Hb >11mg/dl have been viewed controls. Data evaluation was once achieved the use of SPSS software. The ordinary suggest hemoglobin (Hb) used to be 11.55g/dL in controls, whereas it was once considered that amongst the instances it was once 9.58g/dL. It would appear that diet, household size, education, social class, gravida, and parity are related with anemia in pregnancy. After adjusting for all the viable covariates there appears to be huge affiliation between Hb degrees and age group, training level, household size, diet, gravida, and parity.
Keywords: Anemia, pregnancy, knowledge, sociodemographic

8.    ASSOCIATION BETWEEN RISK FACTORS AND RECURRENCE OF FEBRILE SEIZURES IN CHILDREN                 AGED 6 MONTHS TO 60 MONTHS                                                                                                             39-43
 
       Dr. Dinesh Rajwaniya                                                                                                                PDF FULL TEXT

ABSTRACT

Background. Febrile seizures are the most common neurologic disorder among infants and young children. Hence present study was conducted to estimate the various risk factors for recurrence of febrile seizures in children aged 6 months to 60 months admitted in our tertiary care hospital. Methods. In this prospective observational study, 223 children were diagnosed as having febrile seizure based on the clinical presentation and enrolled. All the children were followed up for 24 hours from the onset of fever. Results. 111 children (49.8%) had developed recurrent FS in the upcoming years. Age less than 1 year, male sex, duration of fever less than 24 hours, multiple re-febrile seizures, anemia, low serum sodium level at the time of presentation were having statistically significant relationship (p0.05). Conclusions. We concluded from the present study that age at first febrile seizure less than one-year, male sex, duration of fever less than 24 hours, multiple recurrent febrile seizure were having statistically significant relationship (p<0.05) with recurrence of FS. Duration of seizure, family H/o FS, anemia, low serum sodium level at the time of presentation didn‘t have significant relationship with recurrence of FS.
Keywords: Children, febrile seizures, recurrence, risk factors.

9.    EVALUATING THE EFFICACY OF PREEMPTIVE INTRAVENOUS PARACETAMOL VERSUS TRAMADOL               FOR POSTOPERATIVE ANALGESIA: A RANDOMIZED CONTROLLED TRIAL                                     44-47
 
       Dr. Bhupendra Pratap Singh                                                                                                      PDF FULL TEXT

ABSTRACT

Background. Adequate postoperative pain management is crucial for promoting faster patient recovery, minimizing side effects, reducing mental and physiological burdens, and enhancing patient satisfaction. Aims: This prospective study aims to compare the preemptive use of Paracetamol and Tramadol, evaluating their effectiveness in managing postoperative pain. Material & Methods: Conducted in the Department of Anesthesiology of our tertiary care hospital from August 2019 to December 2019, this randomized controlled clinical trial included 60 patients aged 18 to 60 years with ASA I & II undergoing minor elective surgical procedures under general anesthesia (GA). Patients were randomly assigned to two groups: Group P received preemptive Paracetamol, and Group T received preemptive Tramadol hydrochloride. Premedication included inj. glycopyrrolate 0.2 mg and inj. Fentanyl 2μg/kg intravenously, 3 minutes before GA induction. Additionally, patients in Group P received inj. Paracetamol 15 mg/kg intravenously, while those in Group T received inj. Tramadol 2 mg/kg intravenously, 15 minutes before GA induction. Continuous vital signs monitoring was performed, and the number of analgesic doses, duration of surgery, and postoperative side effects at 24 hours were recorded. Results: Both groups were comparable in demographic profile and surgical procedure duration. Group P exhibited statistically significantly lower mean VAS scores (2.45±2.10) compared to Group T (3.83±2.96), with a lower number of rescue analgesics required (1.89±1.03 vs. 2.75±2.13, respectively) (p<0.05). Conclusion: Preemptive intravenous Paracetamol administration demonstrated effective and reliable postoperative pain control under general anesthesia. Postoperative VAS scores and the requirement for rescue analgesics were lower in the Paracetamol group compared to the Tramadol group.
Keywords: Paracetamol, Tramadol, Preemptive use, VAS scale

10.    EVALUATION OF FUNCTIONAL OUTCOME OF ROTATOR CUFF REPAIR - A SIX MONTHS
         PROSPECTIVE STUDY                                                                                                                           48-53
 
         Dr. Ankur Jain                                                                                                                           PDF FULL TEXT

ABSTRACT

Background. Rotator cuff injuries are a prevalent issue affecting millions worldwide. This study aims to evaluate the efficacy of arthroscopic rotator cuff repair in patients with tears. Methods: In this prospective study, 30 patients of both sexes were recruited from the Orthopedic Department of our Tertiary Care Hospital between January 2020 and June 2020. A thorough assessment was conducted, including a detailed medical history, clinical examination, and radiological evaluation. The UCLA, ASES, and range of motion were assessed preoperatively and during postoperative follow-ups. Results: Most cases (61.2%) involved partial-thickness tears, while 38.8% were full-thickness tears. A substantial improvement was observed in the range of motion, with flexion increasing from 125.27 ± 7.83° preoperatively to 146.88 ± 10.68° at six months. Abduction improved from 126.42 ± 11.22° to 145.18 ± 11.11°, external rotation from 52.24 ± 5.47° to 72.44 ± 7.58°, and internal rotation from 42.21 ± 4.65° to 67.65 ± 4.02°. There were no significant differences in both objective and subjective outcomes between the full anterior repair technique (ART) and the mini-open technique (MO). Conclusions: The results of ART were highly satisfactory, resulting in fewer complications, reduced postoperative pain, shorter hospital stays, and no visible scarring.
Keywords: Rotator Cuff Repair, Arthroscopic Repair, Mini-Open Rotator Cuff Repair.