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Assessment of the Radio-contrast Media-Induced Self-Reported Adverse Drug Reactions in a Tertiary Care Hospital of North India: A Prospective Study 北印度一家三级医院对造影剂诱导的自我报告药物不良反应的评估:一项前瞻性研究
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_381_21
Pushpinder Singh, M. Gill, Mandeep Kaur, R. Mahajan, M. Kaur
Background: Radio-contrast media are the agents which are used on daily basis in the radiological practice for either diagnostic or therapeutic purpose. Currently used agents are considered to be safe but not devoid of side effects. Objectives: Objectives of the study were to assess the incidence of adverse drug reactions (ADRs) in the patients who receive radiographic contrast media for computed tomography (CT) and intravenous pyelography (IVP), to stratify the ADRs into different types based on their time of appearance and as per their severity. Materials and Methods: A prospective and observational study of 1-year duration was done on all the patients who received radio-contrast media (Iohexol) intravenously for CT and IVP in the radiodiagnosis department. Patients who experienced ADRs were recorded for the basic demographic characteristics and types of ADRs. Stratification of ADRs as per their severity was done using common terminology criteria for adverse events scale and Modified Hartwig and Siegel ADR Severity Assessment Scale, and casualty assessment was done using Naranjo's Algorithm. Results: Out of the total 3522 patients who were included in the study, eight patients got 12 suspected ADRs with some of the patients having more than one type of ADR. The most frequent ADR was nausea and vomiting (25%), followed by fever, chills, or sweating. Incidence of ADRs was 0.23%. All the ADRs were acute and occurred within 30 min of contrast administration. As per the severity scales used, all the ADRs were mild (75%) to moderate (25%) in nature with none of the reactions to be severe. Causality assessment showed 87.5% of the reactions to be “probable” in nature. Conclusion: Low osmolar nonionic radio contrast media are associated with very low incidence of ADRs in the North Indian population.
背景:造影剂是在日常放射实践中用于诊断或治疗目的的药剂。目前使用的药物被认为是安全的,但并非没有副作用。目的:本研究的目的是评估在计算机断层扫描(CT)和静脉肾盂造影(IVP)中使用造影剂的患者药物不良反应(adr)的发生率,并根据其出现时间和严重程度将adr分为不同的类型。材料与方法:对所有在放射诊断科静脉注射放射造影剂(碘己醇)进行CT和IVP的患者进行为期1年的前瞻性观察研究。记录发生adr的患者的基本人口学特征和adr的类型。采用不良事件量表和改良Hartwig and Siegel不良反应严重程度评定量表的通用术语标准对不良反应的严重程度进行分层,使用Naranjo算法进行人员伤亡评估。结果:纳入研究的3522例患者中,8例患者出现12例疑似ADR,部分患者出现1种以上ADR。最常见的不良反应是恶心和呕吐(25%),其次是发热、发冷或出汗。不良反应发生率为0.23%。所有不良反应均为急性,并在给药后30分钟内发生。根据使用的严重程度量表,所有不良反应在性质上为轻度(75%)至中度(25%),没有任何反应是严重的。因果关系评估显示87.5%的反应在本质上是“可能的”。结论:低渗透压非离子造影剂与印度北部人群的不良反应发生率非常低有关。
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引用次数: 0
Conceptualizing Problem-Based Learning: An Overview 概念化基于问题的学习:概述
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_827_21
A. Virk, R. Mahajan, T. Singh
© 2022 International Journal of Applied and Basic Medical Research | Published by Wolters Kluwer ‐ Medknow In an attempt to restructure the medical undergraduate curricula so as to equip medical graduates with essential competencies expected of an Indian Medical Graduate (IMG) and to keep pace with the changing dynamics of health in India, the National Medical Commission has introduced competency-based medical education in Graduate Medical Education Regulations-2019.[1] Competency in medical graduates can be developed through the acquisition of knowledge integrated with clinical and attitudinal skills necessary to provide high-quality, effective patient care. Competency development is also influenced by the way medical educators facilitate the growth of an integrated knowledge structure in place of rote memorization of facts or procedural practice.
©2022《国际应用与基础医学研究杂志》|由Wolters Kluwer‐Medknow出版。为了重组医学本科生课程,使医学毕业生具备印度医学毕业生(IMG)的基本能力,并跟上印度不断变化的健康动态,国家医学委员会在《2019年研究生医学教育条例》中引入了基于能力的医学教育。[1]医学毕业生的能力可以通过获得与临床和态度技能相结合的知识来培养,以提供高质量、有效的患者护理。能力发展也受到医学教育者促进综合知识结构发展的方式的影响,而不是死记硬背事实或程序实践。
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引用次数: 7
Trauma to Thrombus: A Case Report of Internal Jugular Vein Thrombosis 血栓创伤:颈内静脉血栓形成1例报告
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_372_21
R. Lavadi, Challapalli Aditya, N. T. Tejaswi Karri, Tanuja Nambakam, S. Lokare
Internal jugular vein (IJV) thrombosis is associated with several etiologies. Trauma is a rarely recorded causative factor. This case presents one such example of how trauma causes IJV thrombosis. A middle-aged woman presented to the general medicine outpatient department with complaints of pain in the base of the left side of the neck and swelling of the left arm and neck for six days. The symptoms had occurred following a trivial trauma to the left side of the neck due to pressure from a 25 L water can. Before the patient came to our hospital, she went to a local clinic, where magnetic resonance imaging was done and showed findings suspicious of thrombosis in her left IJV with extension into adjacent veins. A venous Doppler confirmed the findings. The patient was then treated conservatively with low-molecular-weight heparin, muscle relaxants, and antibiotics. Although uncommon, vascular injuries should also be thought of following minor trauma and not just musculoskeletal events. This case report proposes that IJV thrombosis can also occur without the classical etiological factors.
颈内静脉血栓形成与多种病因有关。创伤是一个很少被记录的致病因素。这个案例提供了一个创伤如何导致IJV血栓形成的例子。一名中年妇女在普通医学门诊就诊,主诉左侧颈部底部疼痛,左臂和颈部肿胀,持续六天。这些症状是在25升水罐的压力对颈部左侧造成轻微创伤后出现的。在患者来到我们医院之前,她去了当地的一家诊所,在那里进行了核磁共振成像,结果显示她的左侧IJV有可疑的血栓形成,并延伸到邻近的静脉中。静脉多普勒证实了这一发现。患者随后接受低分子肝素、肌肉松弛剂和抗生素的保守治疗。虽然不常见,但血管损伤也应考虑在轻微创伤后,而不仅仅是肌肉骨骼事件。该病例报告提出,在没有经典病因的情况下,IJV血栓形成也可能发生。
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引用次数: 0
Free Vascularized Supraclavicular Autologous Heterotopic Lymph Node Transfers Without Skin Paddle for Lymphedema Lower Limb 游离带血管的锁骨上自体异位淋巴结无皮瓣转移治疗下肢淋巴水肿
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_207_21
M. Mir, AJ Praveen, R. Maurya
Free vascularized lymph node transfer (VLNT) is one of the new and highly efficacious procedures in the cases of lymphedema. In this case, we present a case of lower-limb lymphedema which was managed by this procedure where a supraclavicular LN was harvested and transferred to the lower leg. VLNT from the supraclavicular region is a very effective treatment for physiological restoration of the lymphatic flow in established cases of lower-limb lymphedema because of well-hidden favorable scar and minimal chances of secondary iatrogenic lymphedema in the donor region unlike other sites such as groin and axilla. The VLNT should be preferred over manual lymphatic drainage because it is very effective treatment for physiological restoration of the lymphatic flow, however, the further analytical studies are required to confirm statistically the effectiveness of the same over other modalities.
游离血管化淋巴结转移术(VLNT)是治疗淋巴水肿的一种新的高效方法。在这种情况下,我们提出了一个下肢淋巴水肿的病例,该病例通过该手术进行治疗,其中锁骨上LN被采集并转移到小腿。锁骨上区的VLNT是一种非常有效的治疗下肢淋巴水肿患者淋巴流生理恢复的方法,因为与腹股沟和腋窝等其他部位不同,供体区有很好的隐蔽性疤痕,继发性医源性淋巴水肿的机会很小。VLNT应优先于手动淋巴引流,因为它是淋巴流生理恢复的非常有效的治疗方法,然而,需要进一步的分析研究来从统计学上证实其优于其他方式的有效性。
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引用次数: 0
Rare Presentation of Hibernoma as a Cystic Swelling 罕见的冬眠瘤表现为囊性肿胀
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_365_21
P. Sawarkar, B. Mehra, S. Dubhashi, Fatema Kamal
Hibernoma is a rare benign tumor of brown fat origin. It presents as a painless, slowly growing soft tissue tumor mimicking lipoma or liposarcoma, usually affecting adults, with a slight male predominance and a peak of incidence between the third and fourth decades of life. This is a case report of 35-year male, who presented with a mobile, fluctuant and transilluminant, swelling of 7 cm × 5 cm, on medial aspect of the right upper leg. Ultrasonography showed well-defined cystic lesion of varied echotexture with dense internal echoes and septation. Lesion was excised in-toto. On gross examination, it was a subcutaneous, multiseptate cyst containing clear serous fluid with cholesterol crystals with a solid area of 3 cm × 2 cm. Histopathological examination revealed large tumor cells with abundant granular (multivacuolated) cytoplasm. Postoperative recovery period was uneventful. We present this case as cystic degeneration in case of hibernoma.
Hibernoma是一种罕见的褐色脂肪来源的良性肿瘤。它表现为一种无痛、缓慢生长的软组织肿瘤,类似脂肪瘤或脂肪肉瘤,通常影响成年人,男性略占优势,发病高峰在生命的第三到第四十年之间。这是一例35岁男性的病例报告,他表现为右大腿内侧有一个移动的、波动的、透明的、7厘米×5厘米的肿胀。超声检查显示明确的囊性病变,具有不同的回声结构,伴有致密的内部回声和分隔。病灶全部切除。大体检查为皮下多节段囊肿,内含透明浆液和胆固醇晶体,固体面积为3cm×2cm。组织病理学检查显示肿瘤细胞大,胞浆颗粒丰富(多价)。术后恢复期平静。我们将此病例描述为冬眠瘤的囊性变性。
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引用次数: 0
Postplacental Intrauterine Contraceptive Device Transmigration – Rare but the Real Concern for Service Providers 胎盘后宫内节育器移植——罕见但服务提供者真正关注的问题
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_376_21
Shweta Patel, A. Halder, P. Dubey, R. Sanghamita, J. John
Uterine perforation following postplacental intrauterine contraceptive device (PPIUCD) insertion is a rare event with a potential for serious injuries. In the present case, a young lady with a history of PPIUCD insertion presented with a mass having ill-defined margins and restricted mobility palpable in her right iliac region. Examination reported a conglomerated mass in right adnexa with an IUCD surrounded by a heterogeneous inflammatory collection to which omentum and bowel loops adherent to it. Additional imaging reported involvement of right iliac vessels and right ureter with upstream hydroureteronephrosis. Intraoperatively, ureter was found intact and away from the IUCD which was removed with a gentle pull, and a rent in the right posterolateral surface of uterus was repaired with delayed absorbable sutures. With PPIUCD services being provided on an unprecedented scale, it becomes prudent and ethically crucial to create a national repository to document post insertion outcomes and complications. Case report aims to inform and sensitize stakeholders about possible post insertion complications to help improve expansion of the PPIUCD programs.
子宫穿孔后胎盘宫内节育器(PPIUCD)插入是一个罕见的事件与潜在的严重伤害。在本病例中,一位有PPIUCD植入史的年轻女士在她的右髂区域出现了一个肿块,边缘不明确,活动受限。检查报告:右附件有一团块,内含宫内节育器,周围有异质炎性集合,网膜和肠袢附着于其上。其他影像学报告上游输尿管积水累及右髂血管和右输尿管。术中发现输尿管完好且远离宫内节育器,轻轻拔除,并采用延迟可吸收缝线修复右侧子宫后外侧表面的裂口。随着PPIUCD服务以前所未有的规模提供,创建一个国家存储库来记录插入后的结果和并发症变得谨慎和道德上至关重要。病例报告的目的是告知和敏感利益相关者可能的插入后并发症,以帮助改善PPIUCD计划的扩展。
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引用次数: 0
Clinicopathological Aspects of Death due to Wild Mushroom Poisoning: An Autopsy Report 野生蘑菇中毒死亡的临床病理方面:尸检报告
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_517_21
Y. Bansal, Nikhil Mehta, Pulkit Girdhar, Navneet Sharma, S. Kumar, Shikha Gupta
Mushrooms are widely cultivated and used as a source of diet and commerce; however, unfortunately, some wild mushrooms are highly toxic to humans. Although the poisonous mushrooms have a characteristic physical appearance, sometimes it is difficult to differentiate between the poisonous and nonpoisonous variety even by the experts. We report a case of a 23-year-old married female who mistakenly harvested and consumed wild mushrooms along with her family members and subsequently died on the 5th-day postingestion. Due to the medicolegal implications, a forensic autopsy was conducted in this case. Here, we discuss clinical findings along with detailed autopsy findings of this case, including histopathology examination.
蘑菇被广泛种植,并被用作饮食和商业的来源;然而,不幸的是,一些野生蘑菇对人类有剧毒。虽然毒蘑菇有一个特殊的物理外观,但有时即使是专家也很难区分有毒和无毒的品种。我们报告一例23岁的已婚女性误食野生蘑菇并与其家人一起食用,随后在服用后第5天死亡。由于涉及医学法律问题,对此案进行了法医解剖。在这里,我们讨论临床表现以及详细的尸检结果,包括组织病理学检查。
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引用次数: 1
Evaluation of Results of Ponseti Technique in Idiopathic Clubfoot using Clinical Evaluation and Radiological Assessment Ponseti技术治疗特发性马蹄内翻足疗效的临床评价和影像学评价
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_281_21
H. Aggarwal, Ayush Jain, Nitish Kohli, Nitish Bansal, G. Sahni, M. Mathur
Background: Congenital clubfoot (congenital talipes equinovarus) occurs in approximately one in 1000 live births and is one of the most common congenital birth defects. The Ponseti method is at present a well-established method of treatment for idiopathic clubfoot deformities. Aim: The aim of the present study was to evaluate the results of serial casting in clubfoot deformity with Ponseti method on the basis of Pirani's scoring and radiological findings before and after completion of treatment. Materials and Methods: A total of 30 patients were enrolled in the study and were treated with Ponseti's casting after grading the severity of deformity clinically by Pirani's scoring and radiological assessment by calculating the talo-first metatarsal angle in anteroposterior (AP) view and talocalcaneal angle in AP and lateral views. The same clinical and radiological assessment was done at the end of treatment before putting a patient on foot abduction orthosis (FAO). Results: The average number of casts applied before full correction was 5.56 (range: 5–8). The average duration of treatment was about 6.65 weeks before the patient was put on FAO. Pirani score significantly improved from an average of 5.50 (range: 4–6) on presentation to 0.24 (range: 0–2) after correction of deformity. Conclusion: The Ponseti method is an excellent method for the correction of all four deformities associated with congenital idiopathic clubfoot, and we found that the addition of radiographic to clinical evaluation helps in the better assessment of correction. It provides statistically significant results both clinically as measured by Pirani severity score and radiologically assessed by talocalcaneal and talo-first metatarsal angle.
背景:先天性马蹄足(先天性马蹄内翻足)发生在大约千分之一的活产中,是最常见的先天性出生缺陷之一。Ponseti方法是目前公认的治疗特发性马蹄内翻足畸形的方法。目的:本研究的目的是根据Pirani评分和治疗前后的放射学检查结果,评估Ponseti法连续铸造治疗马蹄内翻足畸形的结果。材料和方法:共有30名患者参与了这项研究,并通过Pirani评分和放射学评估对畸形的严重程度进行了临床分级,通过计算前后(AP)视图中的距第一跖骨角和AP和侧视图中的离跟骨角对其进行了放射学评估。在给患者戴上足外展矫形器(FAO)之前,在治疗结束时进行了同样的临床和放射学评估。结果:完全矫正前的平均石膏数量为5.56(范围:5-8)。患者接受FAO治疗前的平均治疗时间约为6.65周。Pirani评分从出现时的平均5.50(范围:4-6)显著提高到畸形矫正后的0.24(范围:0-2)。结论:Ponseti法是矫正先天性特发性马蹄内翻足四种畸形的良好方法,我们发现在临床评估中加入放射学有助于更好地评估矫正效果。它提供了具有统计学意义的结果,无论是通过皮拉尼严重程度评分进行临床测量,还是通过距跟骨和距第一跖骨角进行放射学评估。
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引用次数: 3
Pre-University Health Professional Students' Readiness and Perception Toward Interprofessional Education 大学前卫生专业学生对跨专业教育的准备与认知
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_440_21
Rashmirekha Sahoo, S. Sahoo, Htoo Htoo Kyaw Soe, S. Rai, Jaspal Singh
Background: Interprofessional education (IPE) helps preparing the learners in all healthcare professions to work effectively in collaborative teams. This study was undertaken to assess the readiness and perception of IPE of preuniversity health professional students even before they enter their health professional courses. Methods: The preuniversity health professional students along with final-year medical and dental students were recruited for the study. The readiness for interprofessional learning scale was used to measure the student's readiness toward IPE before the interprofessional-related activity session. The preuniversity students also completed the IEPS scale after their interaction with final-year medical and dental students. Results: Most of the aspiring health professional students during their foundation year expressed positive attitude toward readiness for IPE. Most preuniversity students realized that by learning with various professional students would make them effective member of healthcare team. The students had positive perception toward competence and autonomy, perceived need for cooperation, perception of actual cooperation, and understanding other's value, which were significantly higher from score 3 of somewhat disagree (P < 0.001). Conclusion: Most of the aspiring health professional students in their preuniversity year expressed positive attitude toward readiness for IPE although were not prepared to take roles and responsibility within the interprofessional group. They could well perceive the need for cooperation, perception of actual cooperation, and understanding other's value while working in an IP team.
背景:跨专业教育(IPE)帮助所有医疗保健专业的学习者在协作团队中有效地工作。本研究旨在评估大学预科卫生专业学生在进入卫生专业课程之前对国际政治经济学的准备程度和感知。方法:以大学预科卫生专业学生、医学和牙科专业大四学生为研究对象。本研究采用跨专业学习准备度量表来衡量学生在跨专业相关活动之前对国际政治经济学的准备程度。大学预科学生在与医学院和牙科专业的学生互动后也完成了IEPS量表。结果:大部分有抱负的健康专业学生在预科期间对IPE的准备持积极态度。大多数大学预科学生都意识到,通过与各种专业学生一起学习,可以使他们成为医疗团队的有效成员。学生在能力与自主性感知、合作需求感知、实际合作感知、理解他人价值感知方面的积极感知显著高于“有些不同意”得分3 (P < 0.001)。结论:大多数有抱负的健康专业学生在大学预科阶段表达了积极的态度,尽管没有准备好在跨专业群体中承担角色和责任。当他们在IP团队中工作时,他们能够很好地感知到合作的必要性,感知到实际的合作,并理解他人的价值。
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引用次数: 1
Immunoglobulin-G Antibodies against Severe Acute Respiratory Syndrome – Coronavirus-2 among Health-Care Workers: A Serosurveillance Study from India 卫生保健工作者中抗严重急性呼吸综合征-冠状病毒-2的免疫球蛋白g抗体:来自印度的血清监测研究
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_516_21
Om Prakash, Bhavin Solanki, J. Sheth, H. Acharya, Swati Acharya, M. Vinzuda, Hari Patani
Background: Seropositivity among health-care workers (HCWs) may help in better understanding of the immune response after COVID-19 infection. Objectives: To estimate seropositivity among HCWs and to compare available variables with seropositivity to understand the factors affecting seropositivity. Materials and Methods: A serosurveillance among HCWs was carried out using population proportion sampling during the second half of October 2020 in the city of Ahmedabad using the Covid-Kavach (immunoglobulin G [IgG] ELISA Antibody testing kit). Simple proportions and appropriate statistical tests were used as needed. Results: As on October' 2020, HCWs in Ahmedabad demonstrated a seropositivity of 20.84% (95% confidence interval [CI] 19.00–22.81%). Seropositivity among HCWs was lower than that of the general population (24.20%) which was estimated as part of the same study. Female HCWs had higher seropositivity 22.14% (95% CI 19.74–24.74%) as compared to 18.82% (95% CI 16.06–21.93%) among male HCWs and the difference was statistically not significant (Z = 1.66, P = 0.097). Age groups with increasing age show increasing trend in the seropositivity among HCWs. Conclusion: As on October 2020, with 20.84% seropositivity among HCWs in Ahmedabad, one in every five HCW already demonstrate IgG antibodies against severe acute respiratory syndrome– coronavirus-2. Further scientific studies on seropositivity and the factors affecting the seropositivity may be carried out to uncover more details of immune reaction after COVID-19 infection.
背景:医护人员(HCW)的血清阳性可能有助于更好地了解新冠肺炎感染后的免疫反应。目的:评估HCW的血清阳性率,并将可用变量与血清阳性率进行比较,以了解影响血清阳性率的因素。材料和方法:2020年10月下半月,在艾哈迈达巴德市使用Covid-Kavach(免疫球蛋白G〔IgG〕ELISA抗体检测试剂盒),使用人口比例抽样对HCW进行血清监测。根据需要使用简单的比例和适当的统计检验。结果:截至2020年10月,艾哈迈达巴德的HCW血清阳性率为20.84%(95%置信区间[CI]19.00-22.81%)。HCW的血清阳性率低于同一研究中估计的普通人群(24.20%)。女性HCW的血清阳性率为22.14%(95%CI 19.74–24.74%),而男性HCW的阳性率为18.82%(95%CI 16.06–21.93%),差异无统计学意义(Z=1.66,P=0.097)。随着年龄的增长,年龄组的HCW血清阳性率呈上升趋势。结论:截至2020年10月,艾哈迈达巴德的HCW血清阳性率为20.84%,每五名HCW中就有一人已经表现出针对严重急性呼吸综合征冠状病毒2型的IgG抗体。可以对血清阳性率和影响血清阳性率的因素进行进一步的科学研究,以揭示新冠肺炎感染后免疫反应的更多细节。
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引用次数: 1
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International Journal of Applied and Basic Medical Research
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