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Death due to early pulmonary thromboembolism following tibial fracture: A case report 胫骨骨折后早期肺血栓栓塞导致死亡:病例报告
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.008
Nishanth V.S, T. M. K. Moses, Shipra Tadi, Bharathi Devi Kasireddi, Mahesh Mandala, K. A. Rupesh
Pulmonary Thrombo Embolism (PTE) is primarily attributed to venous thromboembolism, resulting in the obstruction of pulmonary arteries by a thrombus that impedes blood flow to the lungs. The thrombus typically gets lodged at the bifurcation of the main pulmonary artery or the lobar branches, leading to hemodynamic compromise. While the origin of the thrombus is commonly traced back to the lower extremities (Deep Vein Thrombosis, DVT), in rare instances, it may arise from the pelvis, renal veins, upper extremity veins, or right side of the heart. Various factors can contribute to the development of deep vein thrombosis, but in the context of long bone fractures, it is predominantly associated with prolonged immobilization. The typical time frame for DVT to manifest after the injury is 7 to 10 days. However, there have been infrequent cases where PTE has developed within 72 hours of the injury. Several theories have been proposed to elucidate the early onset of PTE in such cases.This report presents a case of early pulmonary thromboembolism in a tibial fracture, as observed during the autopsy examination of a 22-year-old male who succumbed to injuries sustained in a road traffic accident within 6 hours of the incident. Subsequent histopathological analysis following the autopsy revealed the presence of a thrombus in the pulmonary artery.
肺血栓栓塞症(PTE)主要由静脉血栓栓塞症引起,血栓阻塞肺动脉,阻碍血液流向肺部。血栓通常会堵塞在主肺动脉或肺叶分支的分叉处,导致血流动力学受损。虽然血栓的起源通常可追溯到下肢(深静脉血栓,DVT),但在极少数情况下,血栓也可能来自骨盆、肾静脉、上肢静脉或心脏右侧。导致深静脉血栓形成的因素有很多,但就长骨骨折而言,主要与长期固定有关。受伤后出现深静脉血栓的典型时间为 7 到 10 天。不过,也有极少数病例在受伤后 72 小时内发生 PTE。本报告介绍了一例胫骨骨折早期肺血栓栓塞症病例,该病例是在对一名在道路交通事故中受伤的 22 岁男性进行尸检时观察到的,该男性在事故发生后 6 小时内死亡。尸检后的组织病理学分析显示,肺动脉中存在血栓。
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引用次数: 0
A comparative study of patients satisfaction with the quality of nursing care in public and private hospitals in Uttar Pradesh, India 印度北方邦公立医院和私立医院护理质量患者满意度比较研究
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.002
Nitish Kumar
This research paper presents a comparative study on patients' satisfaction with the quality of nursing care in public and private hospitals within Uttar Pradesh, India. The study is motivated by the need to address the disparities in healthcare services and patient experiences between these two sectors. To accomplish this, a comprehensive framework has been developed encompassing literature review, research design, data collection, variables and measures, data analysis, findings, and recommendations. The study's primary objectives are to identify the factors that influence patients' satisfaction with nursing care and to assess the variations in quality between public and private hospitals. Through the analysis of data collected from a representative sample of patients, this study aims to provide valuable insights for policymakers, healthcare providers, and stakeholders in Uttar Pradesh's healthcare system. The findings and recommendations of this research are expected to contribute to the improvement of nursing care quality, ultimately enhancing the overall healthcare experience for patients in both public and private hospitals in the region.
本研究论文介绍了印度北方邦公立医院和私立医院患者对护理质量满意度的比较研究。这项研究的动机是为了解决这两个行业在医疗服务和患者体验方面存在的差异。为此,我们制定了一个全面的框架,包括文献综述、研究设计、数据收集、变量和测量方法、数据分析、研究结果和建议。研究的主要目标是确定影响患者对护理服务满意度的因素,并评估公立医院和私立医院之间的质量差异。通过分析从具有代表性的患者样本中收集到的数据,本研究旨在为北方邦医疗系统的政策制定者、医疗服务提供者和利益相关者提供有价值的见解。本研究的结果和建议有望促进护理质量的提高,最终改善该地区公立和私立医院患者的整体医疗体验。
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引用次数: 0
Assessment of knowledge of accredited social health activists regarding antenatal & neonatal care in a block of Haryana 在哈里亚纳邦的一个街区评估经认可的社会保健活动家对产前和新生儿护理的了解程度
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.004
Seema Sharma, Amit Kumar, Ankesh Poonia, Suryamani Pandey
Improving maternal & child health has been an essential tool for achieving health for all. The discourse on the Accredited Social Health Activist’s (ASHA’s) role centers around three typologies -as an activist, as a link worker or facilitator, and as a community level health care provider.To assess knowledge of ASHA workers regarding antenatal and neonatal care in a block of Haryana. The present cross-sectional, community-based study was conducted in block Barwala, district Hisar of Haryana. Universal sampling technique was used. A predesigned, pretested, semi-structured schedule was used to collect the information, which included details of socio-demographic profile of ASHA workers and questions about knowledge of antenatal & postnatal care. Appropriate statistical tests like frequencies and percentages test were applied to analyze the collected data.Only 6.9% ASHA workers told about benefits of early registration of pregnancy. Majority of ASHA workers had inadequate knowledge about identification of danger signs during pregnancy and infancy, duration of trimester. Majority of ASHA workers had adequate knowledge about breast-feeding practices however about half of ASHA workers had inadequate knowledge about duration of colostrum. Only about one third ASHA workers had adequate knowledge regarding weighing machine & colour zone used for identify malnutrition.: It is important to reorient ASHA workers at field level and supportive supervision also plays an important role.
改善妇幼保健一直是实现全民健康的重要手段。关于经认可的社会保健积极分子(ASHA)角色的论述主要围绕三种类型--积极分子、联系工作者或促进者以及社区保健提供者。本横断面社区研究在哈里亚纳邦希萨尔区的巴瓦拉街区进行。研究采用了普遍抽样技术。研究使用了一份预先设计、经过测试的半结构式调查表来收集信息,其中包括 ASHA 工作者的社会人口概况以及有关产前和产后护理知识的问题。只有 6.9% 的助理助产士和家政服务员了解及早登记怀孕的好处。大多数助理助产士和家政服务人员对孕期和婴儿期危险征兆的识别、孕期持续时间的了解不足。大多数助理助产士和保健员对母乳喂养的做法有足够的了解,但大约一半的助理助产士和保健员对初乳喂养时间的了解不够。只有约三分之一的助理助产士对称重机和用于识别营养不良的色区有足够的了解:在现场对 ASHA 工作人员进行重新定位非常重要,支持性监督也发挥着重要作用。
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引用次数: 0
Angioedema induced by ofloxacin 氧氟沙星诱发的血管性水肿
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.007
Mallinath Parmagond, Sujata Biradar, S.Z Inamdar, Deepak Chinagi, Shrinivas R. Raikar, S. Kolageri
A 42-year-old woman was prescribed the second-generation 4-fluoroquinolone antibiotic ofloxacin to cure loose movements. However, after taking the medication, she developed lip edema. Antibiotics called fluoroquinolones are frequently administered for a variety of medical disorders. The patient was successfully treated with corticosteroids after the diagnosis of ofloxacin-induced hypersensitive reaction was made based on the patient's history, clinical examination, and normal test results. Because ofloxacin, this type of reaction is extremely uncommon. Anti-allergic medicines and drug cessation were used to treat the disease.
一名 42 岁的妇女被处方使用第二代 4 氟喹诺酮类抗生素氧氟沙星来治疗运动松弛。然而,服药后她出现了嘴唇水肿。氟喹诺酮类抗生素经常用于治疗各种疾病。根据患者的病史、临床检查和正常的化验结果,诊断为氧氟沙星诱发的过敏反应后,使用皮质类固醇对患者进行了成功的治疗。由于使用了氧氟沙星,这种反应极为罕见。医生采用了抗过敏药物和停药治疗。
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引用次数: 0
Shaping future healers: The impact and implementation of Early Clinical Exposure in medical education 塑造未来的医者:早期临床接触在医学教育中的影响与实施
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.001
Shivaraj Yadav, A. Piyush, Yashendra Sethi
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引用次数: 0
Perspectives of medical faculty regarding implementation of Competency-Based Medical Education (CBME) in Uttarakhand, India 印度北阿坎德邦医学教师对实施能力本位医学教育(CBME)的看法
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.005
Shivaraj Yadav, Bharti Baluni, Anupama Arya
: Competency Based Medical Education (CBME) introduced in 2019, by the National Medical Commission Erstwhile Medical Council of India, involves restructuring the medical training and planning of curriculum and assessment with a focus on developing competent Indian Medical Graduates.: To assess the perception of medical faculties towards the implementation of new Competency-Based Medical Education.: A cross-sectional study was conducted for 1 Month (July 2023). 42 Faculty Members were enrolled in the study after obtaining their informed consent. A pretested semi-structured questionnaire using Google Forms was used to assess the perception of faculty regarding CBME implementation. Data was entered using MS Excel. Statistical analysis was performed using Stata software (version 11.0, Stata, College Station, Texas). Out of 42 Faculty members,16 were Professors and 26 were Associate Professor. The majority (97.6%) of faculty members were trained in medical education training through various workshops. The majority (69%) of faculty members agreed that CBME is essential as per changing time scenario. Although 81% of faculty members were not happy with frequent changes in regulations as released by NMC after the implementation of CBME. The majority (76%) of faculty members also shared that CBME changed their way of Teaching. Faculty members also unanimously shared that faculty and infrastructure recommended by NMC are less and there is a need to revise recommended requirements for effective implementation of CBME. Faculty members unanimously agreed that Competency-Based Medical Education is very much-needed in India as per evolving and challenging healthcare needs across the globe. However, there is a need to revise (increase) recommended manpower, and infrastructure by NMC for the effective implementation of CBME.
:能力本位医学教育(Competency Based Medical Education,CBME)于 2019 年由国家医学委员会(National Medical Commission)(前身为印度医学理事会)引入,涉及医学培训结构的调整、课程和评估的规划,重点是培养有能力的印度医学毕业生:评估医学院校对实施新的能力本位医学教育的看法:进行了为期 1 个月(2023 年 7 月)的横断面研究。在征得知情同意后,42 名教师参与了研究。研究人员使用谷歌表格制作了一份经过预先测试的半结构化问卷,以评估教职人员对能力本位医学教育实施情况的看法。数据使用 MS Excel 输入。统计分析使用 Stata 软件(11.0 版,Stata,College Station,Texas)进行。在 42 名教师中,有 16 名教授和 26 名副教授。大多数教职员工(97.6%)通过各种讲习班接受了医学教育培训。大多数教职员工(69%)认为,随着时代的变化,CBME 是必不可少的。尽管 81% 的教员对国家医学委员会在实施 CBME 后发布的频繁变更规定感到不满。大多数教员(76%)还表示,CBME 改变了他们的教学方式。教员们还一致认为,国家医学中心建议的师资和基础设施较少,有必要修改建议的要求,以有效实施 CBME。教员们一致认为,根据全球不断发展和具有挑战性的医疗保健需求,印度非常需要能力本位医学教育。然而,为了有效实施能力本位医学教育,有必要修订(增加)国家医学中心建议的人力和基础设施。
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引用次数: 0
Challenges of sustaining leprosy elimination in India and prospects of eradication: Current status & way forwards 印度持续消除麻风病所面临的挑战以及根除麻风病的前景:现状与未来
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.003
MD. Abu Bashar, Imran Ahmed Khan
Leprosy Elimination in India has been a public health priority for decades and on December 31, 2005, India achieved the World Health Organization’s (WHO) goal of eliminating leprosy as a public health problem at the national level, with the prevalence rate falling below one case per 10,000 population. Despite this, India still accounts for the highest number of new leprosy cases globally, contributing more than 50 percent of the leprosy burden of the world. The country has made considerable progress in reducing the burden of leprosy over the years but challenges remain in maintaining the elimination status and preventing disabilities due to leprosy. The present review discusses the current status of leprosy in India, identifies challenges/lacunae in the implementation of the leprosy eradication program, and suggests potential steps that could be undertaken for sustained elimination of leprosy and future possible eradication of the disease from the country.
几十年来,消除麻风病一直是印度公共卫生领域的优先事项。2005 年 12 月 31 日,印度实现了世界卫生组织(WHO)提出的在全国范围内消除麻风病这一公共卫生问题的目标,麻风病发病率降至每万人一例以下。尽管如此,印度仍是全球新增麻风病例最多的国家,占全球麻风病负担的 50%以上。多年来,印度在减轻麻风病负担方面取得了长足进步,但在保持消除麻风病状态和预防麻风病致残方面仍面临挑战。本报告讨论了印度麻风病的现状,指出了在实施根除麻风病计划过程中存在的挑战/不足,并提出了为持续根除麻风病以及未来可能在印度根除麻风病而可能采取的措施。
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引用次数: 0
Pattern and distribution of injuries associated with road traffic accident in Haldwani (Nainital) - An autopsy based study 哈尔瓦尼(奈尼塔尔)道路交通事故相关伤害的模式和分布--基于尸检的研究
Pub Date : 2024-04-15 DOI: 10.18231/j.ijfcm.2024.006
Pooja Hatwal, S. Devassy, C. P. Bhaisora
Indiais one of the fastest growing economies. There is a rapid inflation of vehicles on the road that range from motorcycles to heavy vehicles which also shows an active surge in the fatal road accidents. This study is focussed to find out the pattern and distribution of injuries in fatal road traffic accident cases in Kumaon region of Uttarakhand as to plan at the time of policy making and traffic law implementation.: The present study was conducted in the department of Forensic Medicine & Toxicology of Government Medical College, Haldwani from January 1 2019 to December 31 2019, on total 110 cases of RTA brought to mortuary for medico-legal post mortem examination.: Maximum number of cases sustained head and neck injuries (42 out of 110 externally) followed by extremities injury (28 out of 110). Total 38 cases out of 110 sustained head and neck injuries internally, followed by abdominal injuries (28 cases). Abrasions (30 cases) and laceration (29 cases) were commonest type of external injury noted in RTA cases followed by contusion (22 cases) and fracture (19 cases). Most common cause of death among RTA victims was head injury (40 out of 110 cases) followed by shock and haemorrhage (37 out of 110 cases).
印度是经济增长最快的国家之一。从摩托车到重型车辆,道路上的车辆急剧增加,这也导致了致命道路交通事故的激增。本研究旨在了解北阿坎德邦库蒙地区致命道路交通事故案例中的伤害模式和分布情况,以便在制定政策和实施交通法时进行规划:本研究于 2019 年 1 月 1 日至 2019 年 12 月 31 日在哈尔德瓦尼政府医学院法医学与毒理学系进行,共研究了 110 例被送往停尸房进行法医尸检的致命道路交通事故:头部和颈部受伤的病例最多(110 例中有 42 例外部受伤),其次是四肢受伤(110 例中有 28 例)。110 例中有 38 例头颈部内伤,其次是腹部受伤(28 例)。擦伤(30 例)和撕裂伤(29 例)是意外伤害中最常见的外伤类型,其次是挫伤(22 例)和骨折(19 例)。道路交通意外受害者最常见的死因是头部受伤(110 例中有 40 例),其次是休克和大出血(110 例中有 37 例)。
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引用次数: 0
Assessment of knowledge, perception and intent among health professional students on breastfeeding: A cross sectional study 评估卫生专业学生对母乳喂养的了解、认知和意向:横断面研究
Pub Date : 2024-01-15 DOI: 10.18231/j.ijfcm.2023.032
Anshita Mishra, Samar Hossain, Shweta Goswami, Hobinder Arora, Ekta Arora
To assess knowledge, perception, and intention regarding breastfeeding among medical students. This cross-sectional study assessed the knowledge, perception, and intentions of 198 third-year medical students at Maulana Azad Medical College, New Delhi, regarding breastfeeding. Indicated that 69.6% had average knowledge, with only 3% demonstrating good knowledge. The mean score was 6.39 ± 4.940. Gender and attendance of prior lectures did not significantly influence knowledge levels. The study explored participants' perceptions of breastfeeding policies and found no significant gender-based differences. Additionally, 55 students expressed intent to work in Reproductive and Child Health (RCH) in the future. While not statistically significant, their knowledge scores were higher. The study emphasizes the importance of enhancing breastfeeding education among medical students and highlights the potential role of future healthcare professionals in promoting optimal breastfeeding practices.
评估医学生对母乳喂养的了解、认知和意向。这项横断面研究评估了新德里毛拉纳-阿扎德医学院 198 名三年级医学生对母乳喂养的知识、看法和意向。结果表明,69.6%的学生对母乳喂养的了解程度一般,仅有 3% 的学生对母乳喂养的了解程度较高。平均得分为 6.39 ± 4.940。性别和参加过的讲座对知识水平没有明显影响。研究还探讨了参与者对母乳喂养政策的看法,结果发现没有明显的性别差异。此外,55 名学生表示有意将来从事生殖与儿童保健(RCH)工作。虽然没有统计学意义,但他们的知识得分更高。这项研究强调了在医学生中加强母乳喂养教育的重要性,并突出了未来医疗保健专业人员在促进最佳母乳喂养实践中的潜在作用。
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引用次数: 0
Forensic analysis of illicit liquors in Himachal Pradesh: Assessing toxicity and composition for public health safety 喜马偕尔邦非法酒类的法医分析:评估毒性和成分,确保公共卫生安全
Pub Date : 2024-01-15 DOI: 10.18231/j.ijfcm.2023.027
Gurleen Kaur, Abhilash Thakur, Debhjit Mukherjee, Bhavika Moza
Illicit liquors, also known as illegal, hooch, or bootleg liquors, refer to alcoholic beverages that are produced, distributed, or retailed in defiance of legal regulations and licensing requirements. These beverages are typically produced in clandestine operations, often circumventing taxation, quality control standards, and safety protocols mandated by authorities. The manufacture and consumption of illicit liquors present formidable hazards and complexities. Poisoning incidents linked to illicit liquors can result from contamination with hazardous substances, primarily methanol, alongside compounds such as esters, ketones, aldehydes, and acids, which can inflict deleterious effects on the human body, potentially culminating in fatality. The present study was conducted to perform forensic analysis of illicit liquors in different districts of Himachal Pradesh. In this research, 25 samples of illicit alcohol were meticulously collected from five distinct districts in Himachal Pradesh, namely Kangra, Una, Chamba, Mandi, and Bilaspur. The results of the color test revealed that ethanol might be present, but no other harmful compounds like methanol, or metals like copper and iron were detected. Furfural was found in samples S19, S22, and S23. Following that, samples were tested using an alcolyzer, which detected variations in alcohol percentage and density. Some samples had a higher alcohol percentage, indicating greater toxicity.To further corroborate these findings and identify additional constituents within illicit liquors, the samples underwent scrutiny employing Fourier-transform infrared spectroscopy (FTIR). Prospective research endeavours could expand upon this foundation by augmenting the sample size and employing advanced techniques like gas chromatography-mass spectrometry (GC-MS) for comprehensive quantitative analysis of the diverse components present in illicit liquors.
非法酒类,又称非法酒、私酿酒或私酒,是指无视法律规定和许可要求而生产、分销或零售的酒精饮料。这些饮料通常是秘密生产的,往往规避税收、质量控制标准和当局规定的安全协议。非法酒类的生产和消费具有巨大的危险性和复杂性。与非法酒类有关的中毒事件可能是由于受到危险物质(主要是甲醇)以及酯类、酮类、醛类和酸类等化合物的污染,这些物质会对人体造成有害影响,最终可能导致死亡。本研究对喜马偕尔邦不同地区的非法酒类进行了法医分析。在这项研究中,从喜马偕尔邦的五个不同地区(即康格拉、乌纳、尚巴、曼迪和比拉斯普尔)精心收集了 25 个非法酒精样本。颜色测试结果表明,样品中可能含有乙醇,但没有检测到甲醇等其他有害化合物或铜、铁等金属。在 S19、S22 和 S23 样品中发现了糠醛。随后,使用酒精分解仪对样品进行检测,该仪器可检测出酒精百分比和密度的变化。为了进一步证实这些发现并确定非法酒类中的其他成分,对样品进行了傅立叶变换红外光谱(FTIR)检查。未来的研究工作可在此基础上扩大样本量,并采用气相色谱-质谱法(GC-MS)等先进技术对非法酒类中的各种成分进行全面的定量分析。
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引用次数: 0
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Indian journal of forensic and community medicine
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