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Study of clinical presentation, laboratory profile, transfusion requirements and transfusion-related infectious complications in adult patients of congenital hemolytic anemia in a tertiary care center 某三级保健中心成人先天性溶血性贫血患者的临床表现、实验室资料、输血需求和输血相关感染并发症的研究
Pub Date : 2023-01-01 DOI: 10.5455/jmas.49972
Sarang Kotrange, Dhirendra Yadav, Niteen Karnik, Namita Padwal
Congenital hemolytic anemia (CHA) especially hemoglobinopathies is quite prevalent in certain ethnic groups in India and commonly seen in pediatric age group. Adult presentations are being seen due to better treatment options and increased life span. This study was conducted to determine the clinical profile, laboratory parameters, transfusion requirements, and transfusion-related infectious complications of adult patients with CHA. A total of 84 patients of CHA aged more than 12 years were enrolled and studied over 18 months period. 63% patients were males with mean age of 19.98±4.99 SD years and maximum (57%) in the age group of 13-20 years. Family history of CHA was present in 19 (22.61%) patients and consanguinity in 16 (19.04%) cases which were statistically significant (P<0.05). Easy fatigability (76.19%) was the most common symptom followed by dyspnea on exertion (36.19%), whereas pallor (98.80%) was the commonest finding on examination followed by spleenomegaly (40.47%). The mean average (mean±SD) values for hemoglobin was 7.37±1.23gm/dl, Red blood cell count was 4.71±0.44 million/μL, Mean Corpuscular Volume was 77±5.05 fL, Mean Corpuscular Hemoglobin concentration was 33±1.38 g/dl, Mean Corpuscular Hemoglobin was 23±1.22 pg and mean Mentzer’s index was 16.59±2.24. The most common type of CHA in our study was β thalassemia major (58%), followed by β thalassemia intermedia (17%) and Sickle cell homozygous (13%). 45% of CHA patients required monthly transfusion (p <0.05) especially sickle cell homozygous (90%) and thalassemia major (65%) patients. 24 (28.57%) patients were Hepatitis C virus-positive and 1 was HIV virus-positive. Among adult patients with CHA, β thalassemia major, intermedia and sickle cell anemia were predominant diagnoses. Consanguinity played a role in one-fifth of patients. A majority of the patients had monthly blood transfusion requirements. The high prevalence of hepatitis C virus infection is a major concern.
先天性溶血性贫血(CHA),特别是血红蛋白病在印度的某些民族中相当普遍,常见于儿科年龄组。由于更好的治疗选择和延长的寿命,成年人的表现越来越明显。本研究旨在确定成年CHA患者的临床特征、实验室参数、输血需求和输血相关的感染并发症。本研究共纳入84例年龄大于12岁的CHA患者,研究时间超过18个月。63%的患者为男性,平均年龄19.98±4.99 SD年,13 ~ 20岁年龄组最多(57%)。有CHA家族史的19例(22.61%),有血缘关系的16例(19.04%),差异有统计学意义(P<0.05)。易疲劳(76.19%)是最常见的症状,其次是用力时呼吸困难(36.19%),检查时最常见的症状是面色苍白(98.80%),其次是脾肿大(40.47%)。血红蛋白平均平均值(mean±SD)为7.37±1.23gm/dl,红细胞计数为4.71±0.44万/μL,平均红细胞体积为77±5.05 fL,平均红细胞血红蛋白浓度为33±1.38 g/dl,平均红细胞血红蛋白为23±1.22 pg,平均Mentzer指数为16.59±2.24。在我们的研究中,最常见的CHA类型是β地中海贫血(58%),其次是β地中海贫血(17%)和镰状细胞纯合子(13%)。45%的CHA患者需要每月输血(p <0.05),特别是镰状细胞纯合子(90%)和重度地中海贫血(65%)患者。丙型肝炎病毒阳性24例(28.57%),HIV病毒阳性1例。成年CHA患者主要诊断为重度β地中海贫血、中度和镰状细胞性贫血。血缘关系在五分之一的患者中起了作用。大多数患者每月需要输血。丙型肝炎病毒感染的高流行率是一个主要问题。
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引用次数: 0
Prescription pattern of depressive and anxiety disorders in patients attending Psychiatry outpatient department of a tertiary hospital in Telangana 泰伦加纳邦一家三级医院精神科门诊患者抑郁和焦虑症的处方模式
Pub Date : 2023-01-01 DOI: 10.5455/jmas.36852
Jagathi Nagari, Kavitha Mudavath, Sangeeta Jairaj, Neilofor Hussain
Depression and anxiety are the most common mental illnesses encountered in patients visiting psychiatry outpatient clinics. The relative safety of majority of antidepressants and anxiolytics has increased their routine use. However, limited data is available on the prescribing patterns of these drugs, especially from the state of Telangana. The aim of this study was to assess the prescription pattern in depression and anxiety disorders in patients attending Psychiatry outpatient department of a tertiary care teaching hospital in Telangana. A prospective observational study was conducted in Psychiatry outpatient department in Government General Hospital (GGH), Nalgonda over a period of 6 months (March 2021 to August 2021). A total of 45 patients suffering from anxiety and depression, based on International Classification of Diseases-10th edition (ICD-10), were selected. Data was collected using a semi-structured proforma and analyzed. A total of 103 drugs were prescribed and the average number of drugs per prescription was 2.29. It was found that majority of patients were in 15-35 years age group (60%), female (62.22%), married (60%) and from urban background (82.2%). In the study population, 55.55% were suffering from anxiety disorders, out of which 31.11% had Generalized anxiety disorder. Among the depressive disorders (44.45%) majority had Severe depressive episode (26.67%) followed by Moderate depressive episode (17.78%). The duration of illness was less than 6 months in majority of patients (75.56%). Selective serotonin reuptake inhibitors (SSRIs) were the most common group of drugs prescribed. 41 prescriptions (91.11%) contained SSRIs, and Sertraline was the most common drug followed by Escitalopram. 93.33% of the prescriptions also included Benzodiazepines (Clonazepam). 35.55% of the prescriptions had fixed dose combinations, commonest being Escitalopram 10mg + Clonazepam 0.5mg.
抑郁和焦虑是在精神科门诊就诊的病人中最常见的精神疾病。大多数抗抑郁药和抗焦虑药的相对安全性增加了它们的常规使用。然而,关于这些药物的处方模式的数据有限,特别是来自特伦加纳邦的数据。本研究的目的是评估特伦加纳邦一家三级护理教学医院精神科门诊患者的抑郁和焦虑障碍处方模式。在纳尔贡达政府总医院(GGH)精神病学门诊部进行了为期6个月的前瞻性观察研究(2021年3月至2021年8月)。根据国际疾病分类第10版(ICD-10),共选择了45名焦虑和抑郁患者。采用半结构化形式收集数据并进行分析。处方共103种药物,平均每张处方药物数为2.29种。患者以15 ~ 35岁(60%)、女性(62.22%)、已婚(60%)、城市背景(82.2%)居多。在研究人群中,55.55%患有焦虑症,其中31.11%患有广泛性焦虑症。抑郁症患者以重度抑郁发作为主(占44.45%),占26.67%,其次为中度抑郁发作(占17.78%)。病程小于6个月的患者占多数(75.56%)。选择性血清素再摄取抑制剂(SSRIs)是最常见的药物处方组。41张处方中含有SSRIs类药物,占91.11%,以舍曲林最多,其次为艾司西酞普兰,苯二氮卓类药物(氯硝西泮)占93.33%。35.55%的处方为固定剂量组合,以艾司西酞普兰10mg +氯硝西泮0.5mg最为常见。
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引用次数: 0
Nutrition practices in COVID-19 patients COVID-19患者的营养实践
Pub Date : 2023-01-01 DOI: 10.5455/jmas.40414
S. Saseedharan, Romasha Gupta, Chandrima Pramanik
The COVID-19 pandemic posed a huge challenge to the healthcare system worldwide. India being a developing country, was pushed to the brim of its capabilities due to exhaustion of manpower and financial resources. Currently there are very few studies linked to nutrition in COVID-19 in Indian scenario. In this study we aim to study the nutrition practices among hospitalised Covid-19 patients from tier I and tier II cities of India. An online survey was conducted among 70 COVID hospitals of India from both government and private sector. The data was collected by the use of cloud-based spreadsheet function in googledocs of the selected 70 hospitals. 63 out of 70 respondents used height, weight and BMI criteria to calculate calorie protein requirement of the patients. With the remaining 7, two respondents from government and private hospitals used direct calorimetry and three private hospitals used indirect calorimetry (IC) method. It was observed that the number of patients on EN was higher than PN in wards as well as in ICU. 38 respondents initiated EN within 24 hours, 18 respondents did within 24-36 hrs, of patient’s ICU admission. 39 respondents checked Gastric Residual Volume in patients in prone position on ventilator as part of monitoring. As nutrition is considered equally important in treating COVID-19 patients, it is suggestive that one common government body can be formed which can formulate an India specific standardised nutrition protocol for all the practicing dieticians and health care workers.
2019冠状病毒病大流行给全球医疗体系带来了巨大挑战。印度是一个发展中国家,由于人力和财力的枯竭,它被推向了能力的边缘。目前,在印度,很少有与COVID-19营养相关的研究。在这项研究中,我们的目标是研究印度一二线城市住院的Covid-19患者的营养实践。对印度政府和私营部门的70家新冠医院进行了在线调查。所选70家医院的数据是通过使用googledocs中基于云的电子表格功能收集的。70名受访者中有63人使用身高、体重和BMI标准来计算患者的卡路里蛋白质需求量。其余7名受访者中,两名来自政府和私立医院的受访者使用直接量热法,三名来自私立医院的受访者使用间接量热法。观察到病房和ICU的EN患者人数高于PN。38名应答者在患者入ICU后24小时内启动EN, 18名应答者在患者入ICU后24-36小时内启动EN。39例患者在俯卧位使用呼吸机时检查胃残留量作为监测的一部分。鉴于营养在治疗COVID-19患者中同样重要,建议成立一个共同的政府机构,为所有执业营养师和卫生保健工作者制定印度特有的标准化营养方案。
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引用次数: 0
An outcome of acute kidney injury during pregnancy: An observation and prospective study from tertiary care hospital 妊娠期急性肾损伤的预后:来自三级医院的观察和前瞻性研究
Pub Date : 2022-01-01 DOI: 10.5455/jmas.43027
Priyadarshi Mandal, Sucheta Biswas, Debasish Char, Mrittika Roy, Sangeeta Chhaya
To study the management and outcome of Pregnancy-related Acute Kidney Injury (PRAKI) in obstetrics. This observational and prospective study was conducted in 9270 deliveries including 79 cases of AKI in pregnancy at a tertiary medical college and hospital for the duration of one year. All pregnant and postpartum women attending out patient department (OPD) and emergency as booked and unbooked cases were included in our study. A detailed analysis of all investigations, management and outcome were recorded. Diagnostic criteria of AKI include (a) sudden in onset oliguria (24hrs urine output <400 ml) or anuria (b) serum creatinine level >1.5mg/dl. In the present study the creatinine values during admission or during diagnosis ranged between 1.5 to 18.2 mg/dl with a mean of 4.53±3.24 mg/dl. Majority (51.9%) of the patients have values less than 4 mg/dl. Out of 79 cases, 38 patients required hemodialysis that comes up to 48.1%. Most of the sepsis patients (17 out of 32) required hemodialysis. Case fatality rate due to AKI was 16.46% in our study. Sepsis was responsible for more maternal death, 15.6% in this study. Total 59 patients (74.68%) were discharged in stable conditions.
目的探讨妊娠相关性急性肾损伤(PRAKI)在产科的处理及预后。这项观察性和前瞻性研究在一所三级医学院和医院进行了为期一年的9270例分娩,其中包括79例妊娠期AKI病例。我们的研究包括所有在门诊和急诊就诊的孕妇和产后妇女,包括预约和未预约的病例。记录了所有调查、管理和结果的详细分析。AKI的诊断标准包括:(a)突发性少尿(24hrs尿量1.5mg/dl)。在本研究中,入院时或诊断时的肌酐值在1.5至18.2 mg/dl之间,平均值为4.53±3.24 mg/dl。大多数(51.9%)患者的血压值低于4 mg/dl。79例患者中,38例患者需要血液透析,占48.1%。大多数败血症患者(32例中有17例)需要血液透析。本研究中AKI的病死率为16.46%。脓毒症是导致产妇死亡的主要原因,在本研究中占15.6%。59例出院时病情稳定,占74.68%。
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引用次数: 0
Evaluation of inflammatory markers in COVID-19 positive patients and their correlation with age COVID-19阳性患者炎症标志物的评价及其与年龄的相关性
Pub Date : 2022-01-01 DOI: 10.5455/jmas.93907
Priyanka Singh, Anjana Singh, V. Verma, P. Trivedi, Arshad Ikram
The global widespread of Corona virus disease is still having a catastrophic impact on mankind. COVID-19 has depicted its uncertain adversity in all age groups and the coexistence of co-morbidities have further shown a critical aspect of disease which has additionally ravaged the health status of the patients. The inflammatory markers have exhibited potential usefulness in predicting the outcome of the disease. The Aim of this study is to evaluate the correlation of inflammatory markers in COVID-19 positive patients among various age groups. The study was done on 225 COVID-19 patients, admitted to Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh India, between 1st April-15th June 2021 categorizing into two groups based on their age (≤45 years and >45 years) and then values of various markers were gathered and compared. Among the 225 admitted COVID-19 patients, 78(34.6%) were ≤45 years, while the remaining 147(65.4%) were >45 years. Between these two age groups the aberrant values of inflammatory makers like Neutrophil count (p=0.0001), Lymphocyte count (p=0.0001), Neutrophil to Lymphocyte Ratio (NLR) (p=0.0091), Serum CRP level (p=0.0437), Lymphocyte to C-reactive protein ratio (LCR) (p=0.0007) as well as Serum Ferritin level (p=0.0097) were found to be statistically significant whereas the remaining parameters like Total leucocyte count (TLC) (p=0.0905), Platelet count (p=0.8202) and Platelet to lymphocyte ratio (PLR) (p=0.1513) were statistically insignificant. The results conclude that there was a significant correlation between the age and the inflammatory markers in these patients. Patients with > 45 years had elevated/deranged levels of inflammatory markers, which were associated with the severity and poor prognosis of the disease. Thus, age can be considered as one of the important key risk factor for the severity of COVID-19 in both sexes and hence more clinical attention should be given to elderly age group.
冠状病毒病的全球蔓延仍在对人类造成灾难性影响。COVID-19描述了其在所有年龄组中的不确定逆境,共存的合并症进一步显示了疾病的一个关键方面,这进一步破坏了患者的健康状况。炎症标志物在预测疾病预后方面显示出潜在的有用性。本研究的目的是评估不同年龄组COVID-19阳性患者炎症标志物的相关性。该研究是在2021年4月1日至6月15日期间对印度北方邦巴拉班基梅奥医学科学研究所收治的225名COVID-19患者进行的,根据他们的年龄(≤45岁和bb0 45岁)分为两组,然后收集和比较各种标志物的值。225例新冠肺炎住院患者中,≤45岁的78例(34.6%),≥45岁的147例(65.4%)。在这两个年龄组中,中性粒细胞计数(p=0.0001)、淋巴细胞计数(p=0.0001)、中性粒细胞与淋巴细胞比(NLR) (p=0.0091)、血清CRP水平(p=0.0437)、淋巴细胞与c反应蛋白比(LCR) (p=0.0007)、血清铁蛋白水平(p=0.0097)等炎症标志物的异常值均有统计学意义,而其余参数如总白细胞计数(TLC) (p=0.0905)、血小板计数(p=0.8202)、血小板/淋巴细胞比(PLR) (p=0.1513)差异均无统计学意义。结果表明,这些患者的年龄与炎症标志物之间存在显著相关性。45岁的>患者炎症标志物水平升高/紊乱,这与疾病的严重程度和预后不良有关。因此,年龄可以被认为是影响COVID-19男女严重程度的重要关键危险因素之一,因此临床应更多地关注老年人群。
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引用次数: 0
Clinico-laboratory profile and treatment outcome of persistent diarrhea in under 5-year children of a tertiary care hospital in North India 印度北部一家三级医院5岁以下儿童持续性腹泻的临床-实验室分析和治疗结果
Pub Date : 2022-01-01 DOI: 10.5455/jmas.88304
Hanshika Srivastava, Manisha Maurya, S. Siddiqui, Nandita Mishra, A. Shrivastava
Persistent diarrhea (PD) accounts for a third of all deaths due to diar-rhea in under 5 children. Its etiology and treatment are poorly under-stood. So, we aimed to study various host and environmental risk fac-tors, clinical profile and treatment outcome of PD in children below 5 years of age. 60 children having PD who came to our institute were studied. History taking, clinical examination and investigations were done. Relevant data was collected in form of socio-demographic pro-file, infant and young child feeding (IYCF) indices, anthropometry, in-fections, micronutrient deficiency and secondary lactose intolerance (SLI). The treatment protocol consisted of stepwise diet plan along with supportive measures. All patients were started with diet plan A (low lactose diet), which was prepared by cheap and locally available items. Those who did not respond, were shifted to diet plan B (lactose free diet) and then to diet plan C (monosaccharide-based diet). Successful outcome was defined as decrease in stool frequency along with ade-quate food intake and weight gain. The risk factors associated with PD were found to be age < 2 years, malnutrition, SLI, micronutrient defi-ciency and previous history of infections. Out of total children (n=60), severe acute malnutrition, prior history of diarrhea/pneumonia in past 2 months and anemia were found in 58.3%, 60% and 52% of the PD children respectively. Concomitant enteric and systemic infections were found in 30% and 28.3% of PD children. SLI was observed in 61% of cases and most of the children (75%) improved on diet A only. Proper rehydration, screening and treatment of infections and enteral nutrition-al rehabilitation (both macro and micronutrient) are critical in manage-ment of children with PD.
持续腹泻(PD)占五岁以下儿童腹泻死亡总数的三分之一。其病因和治疗方法尚不清楚。因此,我们旨在研究5岁以下儿童帕金森病的各种宿主和环境危险因素、临床概况和治疗结果。我们研究了60名来到我们研究所的帕金森患儿。进行病史记录、临床检查和调查。相关数据以社会人口统计档案、婴幼儿喂养(IYCF)指数、人体测量、感染、微量营养素缺乏和继发性乳糖不耐症(SLI)等形式收集。治疗方案包括渐进式饮食计划和辅助措施。所有患者开始使用饮食计划A(低乳糖饮食),该计划由当地廉价的物品制备。那些没有反应的人被转移到饮食计划B(无乳糖饮食),然后转移到饮食计划C(以单糖为基础的饮食)。成功的结果被定义为大便频率减少,同时摄入足够的食物和体重增加。与PD相关的危险因素为年龄< 2岁、营养不良、特殊语言障碍、微量营养素缺乏和既往感染史。60例PD患儿中,严重急性营养不良、近2个月腹泻/肺炎病史和贫血分别占58.3%、60%和52%。PD患儿并发肠道和全身感染分别为30%和28.3%。61%的病例出现了特殊语言障碍,大多数儿童(75%)仅通过饮食A得到改善。适当的补液、感染的筛查和治疗以及肠内营养康复(宏量和微量营养素)对帕金森病儿童的治疗至关重要。
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引用次数: 0
Changing trends in medical education during pandemic: our experiences on E learning 大流行期间医学教育的变化趋势:我们的电子学习经验
Pub Date : 2022-01-01 DOI: 10.5455/jmas.81559
Massarat Begum, P. Chalam
The COVID 19 pandemic has lead not just to a social and economic uncertainty but also created historic challenges to the continuity of education process globally. Online teaching and learning has come to the forefront to prevent loss of learning time for students during this period. An observational cross sectional study was conducted on the implementation of online teaching program in a medical college during the period of COVID 19 pandemic. All the synchronous and asynchronous teaching learning activities across all the phases of MBBS were observed and reviewed. The challenges, limitations and opportunities in the implementation process were analyzed. Appropriate solutions were found for most of the challenges including the implementation of competency based undergraduate curriculum for phase 1 MBBS students. Feedback was taken from the undergraduate medical students to know their perceptions on e learning and its use as a teaching learning method. The questionnaire included both closed and open ended questions to know the learning experiences and preferences of the students. The data was subjected to descriptive statistics and computed as frequency percentages. The study presents the challenges in the implementation of online teaching like providing the required infrastructure and training the faculty. It also reveals its limitations in providing clinical experience and conducting assessments for students. The study also shows that though the medical students perceived various features of e learning to be useful but believed traditional classroom to be a better learning environment. The study highlights that e learning has provided the opportunity to promote self directed learning for students and to develop technological skills of both the faculty and the students, suggesting its potential role in the future of medical education.
2019冠状病毒病大流行不仅导致了社会和经济的不确定性,而且给全球教育进程的连续性带来了历史性挑战。在线教学已经走到了最前沿,以防止学生在此期间损失学习时间。对新冠肺炎大流行期间某医学院在线教学项目实施情况进行了观察性横断面研究。对MBBS各阶段的同步和异步教学活动进行了观察和回顾。分析了实施过程中的挑战、限制和机遇。针对大多数挑战找到了适当的解决方案,包括为第一阶段MBBS学生实施基于能力的本科课程。从医科本科学生那里获得反馈,了解他们对电子学习及其作为一种教学学习方法的看法。问卷包括封闭式和开放式问题,以了解学生的学习经历和偏好。对数据进行描述性统计,并以频率百分比计算。该研究提出了实施在线教学所面临的挑战,如提供所需的基础设施和培训教师。它也暴露了它在提供临床经验和对学生进行评估方面的局限性。研究还表明,虽然医学生认为电子学习的各种特点是有用的,但认为传统课堂是一个更好的学习环境。该研究强调,电子学习提供了促进学生自主学习和培养教师和学生技术技能的机会,表明电子学习在未来医学教育中的潜在作用。
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引用次数: 0
A comparative account using student feedback on diverse modules of e-learning used during COVID-19 lockdown for undergraduate medical teaching 利用学生对2019冠状病毒病封锁期间用于本科医学教学的各种电子学习模块的反馈进行比较
Pub Date : 2022-01-01 DOI: 10.5455/jmas.54405
F. Shaikh, K. Naseeruddin, M. Ahmed, Nabila Afsar, Naseem Begum, Madhipati Krishna, A. Chandrasekhar
Need has been the mother of innovation and with the global pandemic of the highly infectious disease COVID 19, there has been a paradigm shift from conventional teaching to digital mode of virtual teaching methods. This task has been achieved by using various platforms available on the digital network, the internet. This work describes the change in medical education, using student feed-back on various modules used in teaching during that period. The feedback survey was conducted online by using the available platforms. The Google forms were used as a survey tool for conducting this survey. The responses were collected from all implied consenting students attending the various teaching sessions across different years of training, belonging to our medical institution. All the participants were adult students attending a medical college. The response rate among the participants was 54%. The respondents were majority 184 (76%) female gender. Nearly 90% opted for Google Meet/classroom as a preferred online module. The choice of selecting this module among the students was found to be statistically significant as compared to other options. The selection was based on the virtue of attributes such as user-friendly application, user satisfaction, beneficial, appealing, less technically challenging, convenient and cost-effective nature. Hence to conclude we may imply to say that this study was unique in assessing the mind of the medical students against this novel e-learning based online mode of education which has taken them by surprise. Though the method is good, there is a lacking that it has; as compared to the conventional means of teaching. This may be used to revise and consolidate the teaching process but not as to replace the classical method rather it should complement it.
需求是创新之母,随着高度传染性疾病COVID - 19的全球大流行,从传统教学模式转向虚拟教学方法的数字模式。这项任务是通过使用数字网络,互联网上的各种平台来实现的。这项工作描述了医学教育的变化,利用学生对那段时期教学中使用的各种模块的反馈。反馈调查是利用现有平台在网上进行的。谷歌表格被用作进行这项调查的调查工具。这些回答是从我们医疗机构所属的所有参加不同年份培训的各种教学课程的隐含同意的学生中收集的。所有的参与者都是一所医学院的成年学生。参与者的回复率为54%。受访者中有184人(76%)为女性。近90%的人选择b谷歌Meet/classroom作为首选的在线模块。与其他选项相比,选择该模块的学生在统计上具有显著性。选择的依据是用户友好、用户满意、有益、吸引人、技术挑战小、方便和成本效益等属性。因此,总结起来,我们可能会暗示说,这项研究在评估医学生对这种新颖的基于电子学习的在线教育模式的看法方面是独一无二的,这种教育模式令他们感到惊讶。方法虽好,但也有不足之处;与传统的教学方式相比。这可以用来修改和巩固教学过程,但不应该取代经典方法,而应该补充它。
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引用次数: 0
MRI evaluation of meniscal injuries of knee with arthroscopy correlation: A comparative study in a tertiary care hospital MRI评价膝关节半月板损伤与关节镜相关性:三级医院的比较研究
Pub Date : 2022-01-01 DOI: 10.5455/jmas.138402
Anil Nethikoppula, vijaypavankumar Dasaraju, S. Tadivaka, Madhavi Gundamaraju, Himaja Gollu, Pavani Kandikanti, Naveen Tirumalasetti
Among various osseous, ligamentous structures around knee meniscus play important role in decreasing load on articular cartilage, smooth movement, reducing friction between opposing articular surfaces of femur, tibia during movement. An accurate diagnosis regarding site, type, grade of meniscal tear along with other associated injury is essential for early operative treatment or non-operative conservative management. This was a descriptive retrospective comparative study to determine the role of MRI in evaluating spectrum and grading of meniscal injuries of knee joint and correlate the findings with arthroscopy. A total of 30 patients clinically suspected of having meniscal injury were evaluated over a period of 1 ½ year from July 2018 to December 2019. Clinical evaluation for meniscal injury with emphasis on medial and lateral joint tenderness, McMurrey test, Appley grinding test were performed by experienced an orthopedician. MRI was performed on 1.5 tesla machine followed by arthroscopy in all patients. Taking arthroscopy as gold standard; sensitivity, specificity, PPV, NPV, accuracy of MRI was determined. In our study, most common meniscal injury was medial meniscal injury (63.3%). Lateral meniscal injury comprised of 33.3%, both menisci were injured in 3.3% of cases. Most common type of tear was longitudinal tear and Grade III tear was most common in both medial and lateral menisci. The sensitivity, specificity, PPV, NPV accuracy of MRI for medial meniscal injury was 94.4%, 83.3%, 89.5%, 90.5%, 90.5%. The sensitivity, specificity, PPV, NPV accuracy of MRI for lateral meniscal injury was 90.0%, 95.0%, 90.0%, 95.0%, 93.3%. There is a good correlation between MRI and arthroscopy findings for meniscal injuries thus supporting MRI as excellent primary non invasive diagnostic tool prior to any invasive arthroscopy.
在膝关节半月板周围的各种骨性、韧带结构中,对减轻关节软骨的负荷,平稳运动,减少运动过程中股骨、胫骨相对关节面之间的摩擦起着重要的作用。准确诊断半月板撕裂及其他相关损伤的部位、类型、等级对于早期手术治疗或非手术保守治疗至关重要。这是一项描述性回顾性比较研究,旨在确定MRI在评估膝关节半月板损伤的频谱和分级中的作用,并将结果与关节镜检查相关联。在2018年7月至2019年12月的1年半时间里,对30例临床怀疑患有半月板损伤的患者进行了评估。由经验丰富的骨科医生进行半月板损伤的临床评估,重点是内侧和外侧关节压痛,McMurrey试验,Appley研磨试验。所有患者均在1.5特斯拉机器上行MRI检查,并行关节镜检查。以关节镜检查为金标准;测定其敏感性、特异性、PPV、NPV、准确性。在我们的研究中,最常见的半月板损伤是内侧半月板损伤(63.3%)。外侧半月板损伤占33.3%,双半月板损伤占3.3%。最常见的撕裂类型是纵向撕裂,III级撕裂最常见于内侧和外侧半月板。MRI对内侧半月板损伤的敏感性、特异性、PPV、NPV准确率分别为94.4%、83.3%、89.5%、90.5%、90.5%。MRI对外侧半月板损伤的敏感性、特异性、PPV、NPV准确率分别为90.0%、95.0%、90.0%、95.0%、93.3%。在半月板损伤的MRI和关节镜检查结果之间有很好的相关性,因此支持MRI在任何侵入性关节镜检查之前作为优秀的初级非侵入性诊断工具。
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引用次数: 0
Onychomadesis, a post infectious sequelae of Hand-Foot-and-Mouth disease: A case report 手足口病感染后后遗症甲发育1例
Pub Date : 2021-01-01 DOI: 10.5455/jmas.61243
Bushra Butul, Neda Fatima, S. Fathima, M. Uddin
Onychomadesis is an idiopathic shedding of a proximal part of the nail as a result of the temporary suspension of a nail matrix function. It is seen in fingernails, toenails, or both. Various underlying causes like systemic illness, drug reactions, Viral diseases, and bullous diseases have been associated with Onychomadesis. However, the mechanism of any such association remains unclear. Here we present a case of On-ychomadesis and Beau lines in the fingernails of a 13-month-old girl following Hand, foot, and mouth disease.
甲生长是指甲近端部分的特发性脱落,由于甲基质功能的暂时中止。它见于指甲、脚趾甲或两者。各种潜在的原因,如全身性疾病、药物反应、病毒性疾病和大疱性疾病,都与软骨发育有关。然而,这种关联的机制尚不清楚。在这里,我们提出了一个13个月大的女孩手、足、口疾病后指甲上的细胞增生和博纹的病例。
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引用次数: 0
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Journal of Medical and Allied Sciences
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