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Comparative study of outcome of the Teaching methods for Early Clinical Exposure in 1st Professional MBBS students: Ward side patient demonstration method Vs Video & Dummy patient demonstration method 医学学士第一专业学生早期临床接触教学方法成果比较研究:病房病人演示法与视频和假病人演示法
Pub Date : 2023-12-20 DOI: 10.58999/cijmr.v2i03.138
B. L. Bamboria, Namit Garg, Nitu Kumari, Anita Choudhary, A. Tripathi, Megha Sharma, Ashish Sharma
Background: Early Clinical Exposure (ECE) is a newer concept of teaching learning methodology which provides clinical perspective and relevance to learning of basic sciences. ECE also orients towards actual clinical scenarios and helps the medical students to correlate their theoretical knowledge with real life situations right from the first year of medical college. Aims and Objectives: This study aimed to compare the outcome of teaching methods for Early Clinical Exposure in 1st Professional MBBS students and to assess the effect and efficiency in their performance. Materials and Methods: This prospective comparative study was carried with a sample population of 50 students of MBBS 1st prof. 2021 batch who were selected by random allocation method and divided into two groups of 25 students each, one acting as Bedside ECE group and other as Virtual ECE group. Pre training evaluation was performed at the beginning of study and Post training evaluation was performed after three months. The student’s feedback was taken regarding advantages, disadvantages and suggestions for further improvement. Results: A statistically significant difference was observed between the Bedside ECE and Virtual ECE group at post training in theory (t=15.682, p<0.001), practical (t=12.671, p<0.001) and total (t=17.460, p<0.001) marks of the students after 3 months training. The mean scores of participants were significantly improved more in the Bedside ECE group (39.92±3.23) as compared to Virtual ECE group (23.04±3.60). Analysis of students’ feedback revealed that Bedside ECE was found to be more interesting method of teaching as compared to virtual methods and helped to develop empathy towards the patients as well as motivated them to read more about the topic and helped in retention. Conclusion: Direct contact with patient has been seen to play a crucial role in development of clinical reasoning, communication skills and professional attitudes. The concept of Bedside Early Clinical Exposure goes longway in helping young minds in grasping clinical and theoretical concepts better by involving all domains of learning. KEY WORDS: Competency Based Medical Education, Early Clinical Exposure, Empathy, Reflection, Bedside ECE, Virtual ECE
背景:早期临床接触(ECE)是一种较新的教学方法概念,为基础科学的学习提供了临床视角和相关性。ECE 还面向实际临床情景,帮助医科学生从医学院一年级开始就将理论知识与实际生活情景联系起来。目的和目标:本研究旨在比较医学学士专业一年级学生早期临床接触教学方法的结果,并评估其效果和效率。材料与方法:这项前瞻性比较研究通过随机分配法选取了 50 名 2021 届 MBBS 第一专业的学生,将他们分为两组,每组 25 人,一组为床边幼教组,另一组为虚拟幼教组。研究开始时进行培训前评估,三个月后进行培训后评估。学生对培训的优缺点和进一步改进的建议进行了反馈。结果床边幼教组和虚拟幼教组的学员在三个月的培训后,在理论(t=15.682,p<0.001)、实践(t=12.671,p<0.001)和总分(t=17.460,p<0.001)方面的差异有统计学意义。与虚拟幼教组(23.04±3.60)相比,床边幼教组学员的平均分(39.92±3.23)明显提高。对学员反馈的分析表明,与虚拟教学法相比,床旁幼教法更有趣,有助于培养学员对病人的同情心,激励他们阅读更多相关内容,并有助于学员保留知识。结论与病人的直接接触在培养临床推理能力、沟通技巧和专业态度方面发挥着至关重要的作用。床旁早期临床接触的概念通过涉及所有学习领域,可帮助年轻人更好地掌握临床和理论概念。关键字:基于能力的医学教育、早期临床接触、移情、反思、床旁幼教、虚拟幼教
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引用次数: 0
A Rare Case of Giant Pulmonary Bullae Compressing the Heart with a Brief Review 巨型肺大泡压迫心脏的罕见病例简述
Pub Date : 2023-12-20 DOI: 10.58999/cijmr.v2i03.125
Meet Bhanushali, Kriti Dwivedi, A. Julka, M. Singapurwala, Swapnil Jain, J. Agrawat
Introduction: An air space of >1cm and air space occupying >1/3 of hemithorax are called as bullae and Giant Pulmonary Bullae (GPB), respectively. GPBs are rare and usually accompany smoking abuse-related diseases. The GPB may lead to hypoxia and or mass-like compression effect on neighboring healthy lung and mediastinum. The bullectomy is the gold standard but in surgically unfit cases one has to select result result-oriented, minimal-invasive procedure with considering risk and benefit.Case report: A 27-year-old chest symptomatic female with idiopathic GPB occupying most of the right hemithorax with herniation to the contralateral side was detected on CT thorax with low cardiac ejection fraction on ECHO. A tremendously improved cardiac ejection fraction from 30 to 58% was achieved after a simple percutaneous intracavitary placement of a pigtail catheter with an underwater seal carried out with local anesthesia. Also, she could be weaned off from O2 support.Discussion: In a surgical unfit case of GPB the number of bullae, its size, site, and location (unilateral or bilateral) with evaluation of the underlying condition of lung and comorbidity is a prerequisite for intervention. An alternate minimally invasive procedure is to have opted to decompress the GPB. Spontaneous pneumothorax is the most common complication GPB, even without a percutaneous procedural approach, and can easily be managed with an underwater seal drainage tube.Conclusion: The GPB may lead to chronic hypoxia and a mass-like effect, so to avoid life-threatening emergency situations decompression of GPB be considered followed by resection
简介大于 1 厘米的气腔和占半胸腔 1/3 以上的气腔分别称为鼓室和巨大肺鼓室(GPB)。GPB非常罕见,通常伴随吸烟相关疾病。GPB 可能会导致缺氧,或对邻近的健康肺和纵隔产生肿块样压迫效应。肺大泡切除术是金标准,但对于不适合手术的病例,必须在考虑风险和获益的情况下选择以结果为导向的微创手术:病例报告:一名 27 岁的女性胸部症状患者,特发性 GPB 占据了右侧胸腔的大部分,并向对侧突出,CT 胸部检查发现其心脏射血分数较低,ECHO 检查发现其心脏射血分数较低。在局部麻醉的情况下,通过简单的经皮腔内置入带水下密封的尾纤导管,她的心脏射血分数从 30% 大幅提高到 58%。此外,她还可以脱离氧气支持:讨论:对于不适合手术的 GPB 病例,考虑鼓室的数量、大小、部位和位置(单侧或双侧)并评估肺部的基本情况和合并症是进行干预的先决条件。另一种微创手术是选择对 GPB 进行减压。自发性气胸是 GPB 最常见的并发症,即使没有采用经皮手术方法,也可以通过水下密封引流管轻松处理:GPB可能导致慢性缺氧和肿块样效应,因此为避免危及生命的紧急情况,应考虑对GPB进行减压,然后再进行切除。
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引用次数: 0
Study of Maternal Near Miss by Near Miss: Mortality Ratio, Exploring Quality of Care 按 "险情 "研究孕产妇险情:死亡率,探讨护理质量
Pub Date : 2023-12-20 DOI: 10.58999/cijmr.v2i03.126
Shany John, Vandana Patidar, Kalpana Mahadik
Introduction: Near Miss being a proxy indicator of MMR, evaluation of facility services and Near Missnumbers was carried out in a teaching hospital in Central India. Sustainable Development Goal targetsMMR less than 70 by year 2030. This study aims to report and evaluate causal factors of maternal nearmiss ratio, maternal death ratio as it is a sensitive indicator of medical care given by the facility. Criticalcare services were quantified in this study.Methods: 4422 number of delivery files occurring over a period of 3 years were included in aretrospective manner. Maternal deaths were 21, Near Miss 170 and live births 4237. Variables studiedwere Maternal near miss ratio, Maternal near miss mortality ratio, mortality index and final diagnosisof each patient. The number of blood components, urgent surgery, ventilator, ICU stay, dialysis andnumber of fourth-generation antibiotics were studied for calculating risk factors against variousdiagnoses. Bi-variate analysis and percents were statistical tools used.Results: Maternal near miss ratio was 40.12, the maternal near miss mortality ratio 8.09:1, and mortalityindex 10.99%. The findings included 85.3% blood transfusion use, 61.8% surgical intervention, 38.2%inotrope, 32.4% ventilator, 96% ICU and 96% fourth generation antibiotic use. Odds for comparisonof services given for various different etiological conditions with respect to MNM ratio and MNMMortalityratio was statistically significant for our data; giving a positive and better ranking to servicesin this Institute.Conclusion: The maternal near-miss ratio of 40.12, Mortality index of 10.99% and MNM – Mortalityratio 8:1 are the major findings of this study.Odds for comparative statements between other reportsand others showed statistical significance.
导言:近乎失误是 MMR 的替代指标,在印度中部的一家教学医院对设施服务和近乎失误数字进行了评估。可持续发展目标要求到 2030 年产妇死亡率低于 70%。本研究旨在报告和评估孕产妇失误率和孕产妇死亡率的成因,因为这是衡量医疗机构所提供医疗服务的敏感指标。本研究对危重症护理服务进行了量化。方法:以回顾性方式纳入了 3 年内发生的 4422 份分娩档案。产妇死亡 21 例,险些死亡 170 例,活产 4237 例。研究变量包括孕产妇险些死亡比率、孕产妇险些死亡比率、死亡指数和每位患者的最终诊断。为计算各种诊断的风险因素,还研究了血液成分、紧急手术、呼吸机、重症监护室住院、透析和第四代抗生素的数量。统计工具包括双变量分析和百分比:产妇险些失救率为 40.12,产妇险些失救死亡率为 8.09:1,死亡率指数为 10.99%。调查结果显示,输血使用率为 85.3%,外科手术使用率为 61.8%,肌注使用率为 38.2%,呼吸机使用率为 32.4%,重症监护室使用率为 96%,第四代抗生素使用率为 96%。就我们的数据而言,针对各种不同病因所提供的服务与产妇死亡率和新生儿死亡率的比较具有显著的统计学意义,从而为该研究所的服务提供了积极和更好的排名:本研究的主要发现是孕产妇近失能率为 40.12,死亡率指数为 10.99%,MNM-Mortalityratio 为 8:1。
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引用次数: 0
Distribution and Determinants of Obesity among Adults Attending Health Facilities of a Medical College in Ujjain 乌贾因一所医学院医疗机构就诊的成年人中肥胖症的分布和决定因素
Pub Date : 2023-12-20 DOI: 10.58999/cijmr.v2i03.146
K. Deshpande, Archit Khardenavis
Introduction: Obesity is a significant risk factor for various serious health conditions, includinghypertension, diabetes, cardiovascular diseases, and cancers. With increasing socio-economic statusand life expectancy in India, the prevalence of obesity is on the rise, contributing to the burden oflifestyle-related disorders. This study aims to investigate the distribution and determinants of obesityamong apparently healthy adults attending health facilities in a medical college located in a rural areaadjoining Ujjain city.Methods: A cross-sectional study was conducted within the field practice area of the Department ofCommunity Medicine at R.D. Gardi Medical College. A sample size of 354 participants was determinedand data was collected through structured interviews covering socio-demographic information,medical history, anthropometric measurements, and determinants of health. Body mass index (BMI)was computed and participants were classified based on established cut-off points for Asian Indians.Results: Out of 310 fully completed questionnaires, 47.4% of participants were overweight or obese.Age was significantly associated with obesity, with prevalence increasing from 34.1% in the 18 to 30age group to 75% in participants over 60 years. Urban residents had a higher prevalence of obesitycompared to rural residents (53.8 vs 44.1%). Higher educational status, overeating between meals, andwatching television while eating was significantly associated with obesity. Physical inactivity was moreprevalent among overweight or obese participants (59.7 vs 26.3%).Conclusion: The study finds the need for tailored interventions to combat obesity, especially amongfemales, older individuals, urban residents, and those with higher education. Addressing lifestylefactors such as overeating and sedentary behavior is essential in the battle against obesity and associatedchronic diseases.
导言:肥胖是导致各种严重健康问题的重要风险因素,包括高血压、糖尿病、心血管疾病和癌症。随着印度社会经济地位的提高和预期寿命的延长,肥胖症的发病率也在不断上升,加重了与生活方式有关的疾病的负担。本研究旨在调查在乌贾因市毗邻农村地区的一所医学院医疗机构就诊的表面健康成年人中肥胖的分布情况和决定因素:在 R.D. Gardi 医学院社区医学系的野外实习区进行了一项横断面研究。研究确定了 354 名参与者的样本量,并通过结构化访谈收集数据,访谈内容包括社会人口信息、病史、人体测量和健康决定因素。根据已确定的亚裔印度人分界点计算身体质量指数(BMI)并对参与者进行分类:在 310 份填写完整的调查问卷中,47.4% 的参与者超重或肥胖。年龄与肥胖有显著关联,18 至 30 岁年龄组的肥胖率为 34.1%,60 岁以上年龄组的肥胖率为 75%。城市居民的肥胖率高于农村居民(53.8% 对 44.1%)。受教育程度较高、两餐之间暴饮暴食和边吃边看电视与肥胖有明显关系。在超重或肥胖的参与者中,缺乏运动的比例更高(59.7% 对 26.3%):研究发现,有必要采取有针对性的干预措施来对抗肥胖,尤其是女性、老年人、城市居民和受过高等教育的人群。解决暴饮暴食和久坐不动等生活方式因素对于防治肥胖症和相关慢性疾病至关重要。
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引用次数: 0
Insight of Yoga Nidra: Scientific Basis 瑜伽冥想的启示:科学依据
Pub Date : 2023-12-20 DOI: 10.58999/cijmr.v2i03.148
Anita Choudhary
When awareness is separate and distinct from mental activity, When waking, dream and deep sleep pass like clouds, Yet awareness of Self remains, This is the experience of total relaxation…That is why, in tantra, Yoga Nidra is said to be the doorway to Samadhi.1”- Swami Satyananda
当觉知与心理活动分离并截然不同时,当清醒、梦境和深度睡眠如云雾般消散时,对自我的觉知依然存在,这就是完全放松的体验......这就是为什么在密宗中,瑜伽念珠被称为通往三摩地的大门1"--斯瓦米-萨蒂南达
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引用次数: 0
Enhancing Patient-Centered Care and Health Outcomes through Patient-Reported Outcome Measures 通过 "患者报告的结果衡量 "加强以患者为中心的护理和健康结果
Pub Date : 2023-12-20 DOI: 10.58999/cijmr.v2i03.131
Aditya S. Berad
Patient-reported outcome measures (PROMs) have gained prominence as valuable tools for assessingpatient experiences and outcomes in healthcare. This article explores the role of PROMs in enhancingpatient-centered care, facilitating shared decision-making, and improving overall health outcomes. Theimplementation, benefits, challenges, and future prospects of PROMs are discussed
患者报告结果指标(PROMs)作为评估患者就医体验和医疗效果的重要工具,已日益受到重视。本文探讨了 PROMs 在加强以患者为中心的护理、促进共同决策和改善整体医疗效果方面的作用。文章讨论了 PROMs 的实施、益处、挑战和未来前景。
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引用次数: 0
How to Formulate a Research Question, Hypothesis and Objective for a Clinical Study? 如何为临床研究制定研究问题、假设和目标?
Pub Date : 2023-12-20 DOI: 10.58999/cijmr.v2i03.133
S. N. Dwivedi
A research study mainly addresses a specific research question (s) which is to be primarily answeredafter completion of that clinical study. As such, the considered research question decides the hypothesisof the study. Ultimately, the hypothesis of a study determines the objectives of that study. Generally, astudy’s planning also relies on the primary research question/objective of that study. Keeping in viewof the pivotal role of these facts, the present write-up aims to briefly address important issues whiledeciding the research question, hypothesis and objective (s) of a clinical study.
一项研究主要针对一个(多个)具体的研究问题,这些问题将在临床研究完成后给出主要答案。因此,研究问题决定了研究假设。最终,研究假设决定了研究目标。一般来说,一项研究的规划也取决于该研究的主要研究问题/目标。鉴于这些事实的关键作用,本文旨在简要讨论在确定临床研究的研究问题、假设和目标时遇到的重要问题。
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引用次数: 0
Association between Deranged Liver Function Tests and Radiological Severity Indicators in COVID-19 Patients COVID-19 患者肝功能检测紊乱与放射学严重程度指标之间的关系
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.112
A. Tripathi, Kratika Singh, Prabhakar Gupta, Ajay Adhikari, Ajay Verma, Tejaswini Dwivedi
In this retrospective observational study data of 30 COVID-19 positive confirmed cases was extracted from medical archives of RD Gardi Medical College Hospital, and this data was analysed. Liver function tests like SGOT, SGPT and total bilirubin were compared to radiological indicators of increased lung involvement in these 30 patients. It was found that there is significant association between increased involvement of lung tissue damage and derangement of liver function tests of these patients at the time of admission. Lung tissue involvement was calculated as per radiologically established scores for assessing severity of COVID-19.
在这项回顾性观察研究中,我们从 RD Gardi 医学院医院的医学档案中提取了 30 例 COVID-19 阳性确诊病例的数据,并对这些数据进行了分析。将这 30 名患者的肝功能检测(如 SGOT、SGPT 和总胆红素)与肺部受累程度增加的放射学指标进行了比较。结果发现,这些患者入院时肺部组织损伤累及程度的增加与肝功能检测结果的失常之间存在明显关联。肺组织受累情况是根据放射学上确定的 COVID-19 严重程度评估评分计算得出的。
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引用次数: 0
YOGA eye exercises and Refractive Errors YOGA 眼保健操与屈光不正
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.130
Snehal Mahadik, S. Khare, Vinod Diwan
The article delves into the prevalent issue of refractive errors, a common visual problem affecting a substantial portion of the global population, and particularly emphasizes its growing occurrence among school-going children. The surge in digital device usage due to the COVID-19 pandemic has amplified concerns, as extended screen time contributes in worsening the existing problem of poor vision. The article underscores the multifaceted impact of unaddressed refractive errors on children, including hindered academic performance, impaired social interactions, and a sedentary lifestyle. Socioeconomic and demographic factors play a role in the prevalence of refractive errors, with limited access to eye care services disproportionately affecting lower-income families. The importance of early diagnosis and intervention is highlighted to prevent unwanted consequences. A significant portion of the article explores the potential role of yoga in mitigating refractive errors. Yoga's holistic approach, incorporating eye exercises, mindfulness, stress reduction, and outdoor practice, offers promise in promoting eye health. While acknowledging that yoga may not correct refractive errors, the article emphasizes its potential to reduce eye strain caused by screen time and near-work activities, ultimately fostering healthier habits and overall well-being in children. The article concludes by emphasizing the need for complementary practices alongside standard eye care to ensure children's visual health and academic success while suggesting that embracing yoga could be a step toward safeguarding children's eye health and quality of life.
文章深入探讨了屈光不正这一影响全球大部分人口的常见视力问题,并特别强调了这一问题在学龄儿童中的日益严重。由于 COVID-19 的流行,数字设备的使用量激增,这加剧了人们的担忧,因为长时间使用屏幕会导致现有的视力不良问题恶化。文章强调了未解决的屈光不正问题对儿童造成的多方面影响,包括学习成绩下降、社会交往障碍和久坐不动的生活方式。社会经济和人口因素在屈光不正的发病率中扮演着重要角色,而获得眼科保健服务的机会有限对低收入家庭的影响尤为严重。文章强调了早期诊断和干预对预防不必要后果的重要性。文章的很大一部分内容探讨了瑜伽在缓解屈光不正方面的潜在作用。瑜伽的整体方法融合了眼保健操、正念、减压和户外练习,为促进眼睛健康带来了希望。文章承认瑜伽可能无法矫正屈光不正,但强调瑜伽有可能减轻屏幕时间和近距离工作活动造成的眼睛疲劳,最终培养儿童更健康的生活习惯和整体健康。文章最后强调,在提供标准眼科护理的同时,还需要提供辅助性护理,以确保儿童的视力健康和学业成功,同时建议人们将瑜伽作为保障儿童眼睛健康和生活质量的一个步骤。
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引用次数: 0
Comparison of Michaelis Rhombus, Height and Foot Length of Patient in Prediction of Mode of Delivery 米凯利斯菱形、身高和脚长在预测分娩方式中的比较
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.111
Deepika Jain, Priyanka Bramhwanshi, Pulak K. Roy, Kalpana Mahadik
Background: The Michaelis rhombus, a diamond-shaped area in the lower back is easy to measure. During labor it is thought to move posteriorly, pushing out the wings of the ileum and increasing the diameter of the pelvis. Comparison of Michaelis Rhombus, height and foot length of patient in has been used as a simple means to identify women at risk of cephalo-pelvic disproportion and help in prediction of a safe mode of delivery. Aim and Objective: The present study was conducted to evaluate the Michaelis rhombus as predictor of contracted pelvis and to compare its efficacy to other measures like maternal height and foot length of labouring and or antenatal mothers.  Method: This is a Prospective Observational comparative study conducted on 220 antenatal pregnant women who were admitted at the Department of Obstetrics and Gynaecology, R. D. Gardi Medical college and C.R.G. Hospital, Surasa, Ujjain (M.P.), India. This study was carried out on pregnant women in the age group of 19-35 years, which were coming for delivery in our hospital with gestational age >36 weeks. Result: Out of 220 subjects 190 delivered by normal delivery and 30 subjects by LSCS. Transverse diagonal was significantly lower in LSCS mean 9.53±0.69 cm as compared to normal delivery where transverse diagonal [mean 10.59±0.55 cm] (p = 0.000). Vertical diagonal was lower in LSCS cases (mean 10.73±0.87 cm) as compare to normal delivery where vertical diagonal (mean 11.94±0.73 cm). Foot length was significantly lower in LSCS cases with mean 23.12±1.28 cm as compared to normal delivery with mean 24.48±1.05 cm. Height was significantly lower in LSCS cases with mean 148.23±5.56 cm as compared to normal delivery with mean 153.94±3.31 cm. Conclusion: Anthropometric parameters like Michaelis rhombus, height, foot length can be used as predictor of contracted pelvis. These measurements help to increase ease of patient for clinical assessment of pelvis by decreasing multiple per vaginal examination, thereby decreasing chances of infection.
背景:米凯利斯菱形是腰部的一个菱形区域,很容易测量。在分娩过程中,它被认为会向后方移动,将回肠的两翼挤出并增加骨盆的直径。比较患者的米凯利斯菱形、身高和脚长已被用作一种简单的方法来识别有头盆不称风险的产妇,并帮助预测安全的分娩方式。目的和目标:本研究旨在评估米凯利斯菱形作为骨盆收缩预测指标的效果,并将其与产妇身高和足长等其他测量指标进行比较。 研究方法这是一项前瞻性观察比较研究,对象是印度乌贾因(M.P.)苏拉萨 R. D. Gardi 医学院和 C.R.G. 医院妇产科收治的 220 名产前孕妇。这项研究的对象是 19-35 岁年龄组的孕妇,她们都是来本医院分娩的,孕周大于 36 周。结果在 220 名受试者中,190 人顺产,30 人 LSCS。与顺产的横对角线[平均为 10.59±0.55 厘米]相比,LSCS 的横对角线明显较低,平均为 9.53±0.69 厘米(P = 0.000)。与顺产的垂直对角线(平均为 11.94±0.73 厘米)相比,LSCS 病例的垂直对角线较低(平均为 10.73±0.87 厘米)。LSCS 病例的足长(平均值为 23.12±1.28 厘米)明显低于正常分娩的足长(平均值为 24.48±1.05 厘米)。LSCS 患儿的身高(平均值为 148.23±5.56 厘米)明显低于顺产(平均值为 153.94±3.31 厘米)。结论Michaelis菱形、身高、足长等人体测量参数可用于预测骨盆收缩。这些测量有助于减少每次阴道检查的次数,从而降低感染的几率,使患者更容易对骨盆进行临床评估。
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引用次数: 0
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Central India Journal of Medical Research
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