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A study to compare the performance of students following self-directed learning sessions conducted without online support and self-directed learning sessions conducted with the help of online support in the department of physiology 一项比较生理学系学生在没有网络支持的情况下自主学习和有网络支持的情况下自主学习的表现的研究
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_27_22
P. Sinha, Arun Chaudhuri, D. Adhya
Background: Medical students need to develop self-directed learning (SDL) skills to become life-long learners. Aims: To compare the performance of students following SDL sessions conducted in the offline mode and SDL sessions conducted with the help of online support in the department of physiology. Methodology and Participants: This study was conducted on 200 first-phase MBBS students (Batch 21–22) after taking Institutional Ethical Clearance and informed consent of the participants. Nerve muscle physiology was taught using the two methods of SDL. The assessment was done using multiple choice questions. Pre-test and post-test were conducted for all sessions and ten such sessions were assessed in the present study. Feedback was taken from students and facilitators. Program evaluation was done using Kirkpatrick level 1 evaluation. Pre-test and post-test scores of the same group were compared using the paired t-test and among two groups were compared using an unpaired t-test. Results: Students performed significantly better in SDL sessions where online support was better and the performance of female students was significantly better as compared to male counterparts (87.27 ± 7.09 vs. 84.79 ± 8.49; P<0.001**). Students were satisfied with the SDL sessions and more so with online support. Faculty members and students emphasized that online support increased bonding among students as well as bonding with the facilitators. Conclusions: Providing online support to medical students was found to have positive effects on learning in the present study. Female students developed better problem-solving attitudes and critical thinking abilities as compared to males and were more motivated in learning.
背景:医学生需要培养自主学习(SDL)技能,成为终身学习者。目的:比较生理学系线下模式和在线支持模式下SDL学生的表现。方法和参与者:本研究在获得机构伦理许可和参与者知情同意后,对200名第一阶段MBBS学生(第21-22批)进行了研究。采用两种方法进行神经肌肉生理学教学。评估采用多项选择题。本研究对所有阶段进行了前测和后测,并对10个阶段进行了评估。反馈来自学生和辅导员。项目评估采用Kirkpatrick 1级评估。同一组的前测和后测成绩采用配对t检验比较,两组间采用非配对t检验比较。结果:在线支持较好的学生在SDL课程中表现较好,女学生的表现显著优于男学生(87.27±7.09 vs. 84.79±8.49;P < 0.001 * *)。学生们对SDL课程感到满意,对在线支持更是如此。教师和学生都强调,在线支持增加了学生之间以及与辅导员之间的联系。结论:本研究发现医学生在线学习支持对学习有积极影响。与男生相比,女生表现出了更好的解决问题的态度和批判性思维能力,在学习上也更有动力。
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引用次数: 0
Femoral hernia: Treatment delay and cause of death – A case report and an integrative review 股骨疝:治疗延迟和死亡原因——一例病例报告和综合评价
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_68_22
Yaqoob Hassan, Abu Shahma, A. Anees, Susheel Kumar
Femoral hernia is an uncommon entity in males and is limited to case reports in the medical literature. Because of the narrow neck of the femoral canal, a femoral hernia can easily incarcerate and/or strangulate. Surgical intervention is the only option for definitive treatment. We report the case of a 59-year-old male patient who presented with a 10 days history of generalised abdominal pain, distension, and a few episodes of vomiting. The patient was resuscitated, and contrast-enhanced CT tomography revealed a left femoral hernia as well as features of small bowel obstruction. A gangrenous ileal loop with perforation within the left femoral canal was discovered after surgery. The patient underwent ileal resection and ileostomy, followed by primary femoral ring repair. However, on postoperative day 3rd, the patient developed a sudden cardiac arrest and died. Proper referral, early diagnosis, and treatment are vital in cases of femoral hernia to avoid such a fatal outcome and could have changed the prognosis of the patient. It is important for peripheral health-care providers to pay attention to persistent abdominal symptoms and to be aware of the proper and timely referral.
股骨疝在男性中是一种罕见的疾病,仅限于医学文献中的病例报告。由于股管颈部狭窄,股疝很容易嵌顿和/或绞窄。手术干预是最终治疗的唯一选择。我们报告了一例59岁的男性患者,他有10天的全身性腹痛、腹胀和几次呕吐病史。患者被复苏,增强CT断层扫描显示左股疝以及小肠梗阻的特征。术后发现左侧股管内有坏疽性回肠环穿孔。患者接受了回肠切除术和回肠造口术,然后进行了初级股环修复。然而,在术后第3天,患者出现心脏骤停并死亡。正确的转诊、早期诊断和治疗对于股疝病例至关重要,以避免这种致命的结果,并可能改变患者的预后。重要的是,外围医疗保健提供者要注意持续的腹部症状,并意识到适当和及时的转诊。
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引用次数: 0
Knowledge of E-Shram card among the rural population of Kurnool district in Andhra Pradesh: A cross-sectional study 安得拉邦Kurnool区农村人口对E-Shram卡的了解:一项横断面研究
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_6_23
Y. Pranaya, Thilak Anjanappa, Komera Sunanda, Ajay Enibera
Background: In India, little thought has been given to how social security programs are used by rural people. Since the people reside in villages, it is possible that they are unaware of these programs and do not fully take advantage of them. E-Shram portal is the first-ever national database of unorganized workers. With registration, workers would get a Universal Account Number card or e-Shram card that allows access to benefits under social security schemes. Hence, the study aimed to assess the knowledge about e-Shram card in Pyalakurthy village. Materials and Methods: A cross-sectional community-based study was carried out among the rural population of Pyalakurthy and 109 members participated in the study. The data were collected using convenient sampling method between April and May 2022. The data were collected using a semi-structured questionnaire through Google Forms, were administered to them by interview method, and were analyzed using Epi-Analysis. Results: A total of 109 participated in the study with a mean age of 42.6 ± 14.7 years, 64 (58.7%) males and 45 (41.3%) females. Nearly three-fourth belonged to Class IV and V socioeconomic status. Only 15% had knowledge about e-Shram card. There was a significant association between knowledge about e-Shram card and education, socioeconomic status, migrants, and smartphone availability. Conclusion: Most of the rural population had poor knowledge about e-Shram card. Creating awareness and doorstep registration services may help them be aware and avail of its benefits.
背景:在印度,很少有人考虑农村人如何使用社会保障计划。由于人们居住在村庄里,他们可能不知道这些计划,也没有充分利用这些计划。E-Shram门户网站是第一个无组织工人的国家数据库。通过注册,工人将获得一张通用账号卡或e-Shram卡,可以获得社会保障计划下的福利。因此,本研究旨在评估Pyalakurthy村的e-Shram卡知识。材料和方法:在Pyalakurthy的农村人口中进行了一项基于社区的横断面研究,109名成员参与了该研究。数据是在2022年4月至5月期间使用方便的采样方法收集的。数据通过谷歌表格使用半结构化问卷收集,通过访谈法进行管理,并使用Epi分析进行分析。结果:共有109人参与研究,平均年龄42.6±14.7岁,其中男性64人(58.7%),女性45人(41.3%)。近四分之三属于第四和第五类社会经济地位。只有15%的人知道e-Shram卡。关于e-Shram卡的知识与教育、社会经济地位、移民和智能手机可用性之间存在显著关联。结论:大部分农村居民对电子政务卡的了解程度较低。创建意识和上门登记服务可以帮助他们意识到并利用其好处。
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引用次数: 0
Identification of the factors that affect clinical teaching and potential strategies to overcome them: A narrative review 影响临床教学的因素识别和克服这些因素的潜在策略:叙述性综述
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_70_22
S. Shrivastava, P. Shrivastava
Clinical teaching does not limit to teaching alone, rather it actually deals with the process wherein students are supported in their learning process while interacting with real patients during clinical settings. The purpose of the current review was to explore the factors that impact clinical teaching and then propose the potential recommendations to overcome them. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines and 39 articles were selected based on their suitability with the current review objectives and analyzed. Keywords used in the search include clinical teaching, patient, student, and teacher in the title alone only. Clinical teaching is affected by a wide range of teacher-related, student-related, and patient-related factors, and as medical educators, we are aware of these factors so that we can minimize their impact to enhance the effectiveness of clinical teaching, thereby augmenting learning among medical students. Most of the identified factors that can influence clinical teaching can be taken care of in one or another way, if we strengthen the domain of the faculty development program. The shortage of patients, this concern can be managed by either adoption of standardized patients or by ensuring clinical teaching in outpatient department settings. To conclude, clinical teaching is an important aspect of the making of a competent medical graduate. However, the effectiveness of such sessions depends immensely on the stakeholders that are involved in the process. It is the need of the hour to identify the prevailing factors and then plan for corrective measures to neutralize the impact of such factors and also simultaneously enhance learning among students.
临床教学并不局限于单独的教学,而是实际处理学生在临床环境中与真实患者互动时在学习过程中得到支持的过程。本综述的目的是探讨影响临床教学的因素,然后提出克服这些因素的潜在建议。在PubMed和Google Scholar搜索引擎上对与该主题相关的所有材料进行了广泛搜索,根据其与当前审查目标的适用性选择了39篇文章并进行了分析。搜索中使用的关键字仅包括标题中的临床教学、患者、学生和教师。临床教学受到广泛的教师相关、学生相关和患者相关因素的影响,作为医学教育工作者,我们意识到这些因素,以便将其影响降至最低,以提高临床教学的有效性,从而增加医学生的学习。如果我们加强教师发展计划的领域,大多数可以影响临床教学的因素都可以通过这样或那样的方式得到解决。患者短缺,这一问题可以通过采用标准化患者或确保门诊部的临床教学来解决。总之,临床教学是培养合格医学生的一个重要方面。然而,此类会议的有效性在很大程度上取决于参与这一进程的利益攸关方。现在需要确定主要因素,然后计划纠正措施,以消除这些因素的影响,同时提高学生的学习水平。
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引用次数: 1
My five moments of hand hygiene: A cross sectional questionnaire based study on adherence and barriers among nurses in central Kerala 我的五个时刻的手卫生:一个横断面问卷基于依从性和障碍在喀拉拉邦中部护士的研究
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_30_22
S. Sebastian, S. Madhumitha, LiyaMariam George, KS Meenakshi, AlphonsaClara Vinson, A. Benjamin
Background: Hospital acquired infections have remained a concern in the field of health care as a major cause of increasing morbidity, mortality and health care costs in healthcare facilities. In the present era of emerging and re-emerging infectious diseases and multidrug resistant pathogens, there is a growing emphasis on basic measures of prevention of infections, like maintaining good hand hygiene. Although The World Health Organization (WHO) has issued guidelines on hand washing procedure with an aim to reduce the prevalence of hospital associated infections, the compliance amongst health care workers is poor. Objective: To study the adherence and barriers relating to non-adherence to the five moments of hand hygiene among nursing staff in Central Kerala. Materials and Methods: The present cross sectional study was conducted among 360 female nurses using Snowball sampling technique. The quantitative data collected was analysed using the software SPSS version 20. Chi-square test was used for comparison of proportions across groups. Logistic regression analyses were used to find out the determinants of non-adherence. The qualitative data collected was analysed using thematic analysis and classified into themes and subthemes. Results: Out of 338 study participants, 304 (90%) reported to be adherent to the 5 moments of Hand Hygiene. The present study found that factors associated with hand hygiene behaviour among study participants were awareness about Hand Hygiene and educational qualification. Conclusion: The existing level of non-adherence can be a source for outbreak of hospital acquired infections in the community and hence needs to be addressed.
背景:医院获得性感染仍然是卫生保健领域的一个令人关切的问题,是卫生保健设施中发病率、死亡率和卫生保健费用不断增加的主要原因。在新出现和再出现传染病和耐多药病原体的当今时代,人们越来越强调预防感染的基本措施,如保持良好的手部卫生。虽然世界卫生组织(世卫组织)发布了洗手程序指南,旨在减少医院相关感染的流行,但卫生保健工作者的遵守情况很差。目的:了解喀拉拉邦中部护理人员对手部卫生五时刻的遵守情况及不遵守的障碍。材料与方法:采用滚雪球抽样方法对360名女护士进行横断面调查。采用SPSS version 20软件对所收集的定量数据进行分析。各组间比例比较采用卡方检验。采用Logistic回归分析找出不依从性的决定因素。采用主题分析法对收集到的定性数据进行分析,并将其分为主题和副主题。结果:在338名研究参与者中,304名(90%)报告坚持5分钟手部卫生。本研究发现,影响参与者手卫生行为的因素是手卫生意识和教育程度。结论:现有的不依从性水平可能是社区医院获得性感染爆发的一个来源,因此需要加以解决。
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引用次数: 1
Chronic obstructive pulmonary disease – A neglected and underestimated chronic lung disease in India: A large single-center study in India 慢性阻塞性肺病——印度被忽视和低估的慢性肺病:印度的一项大型单中心研究
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_48_22
S. Patil, Deepak Patil, G. Gondhali
{"title":"Chronic obstructive pulmonary disease – A neglected and underestimated chronic lung disease in India: A large single-center study in India","authors":"S. Patil, Deepak Patil, G. Gondhali","doi":"10.4103/mjmsr.mjmsr_48_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_48_22","url":null,"abstract":"","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70833764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Toxic granules in neutrophils in sepsis patients: Does it really helpful? 败血症患者中性粒细胞中的毒性颗粒:真的有帮助吗?
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_26_22
Subhash Chander, Reetika Sharma, Anuradha Sharma, Priyanka Verma
Introduction: Timely diagnosis of bacteremia/sepsis is essential for the initiation of antimicrobial therapy and further reducing morbidity and mortality. Aims and Objective: This study is undertaken to find out the importance of toxic granulations in neutrophils in the diagnosis of sepsis. Materials and Methods: This was a cross-sectional type of study which was carried out for 1 year (August 2020 to August 2021). A total of 100 cases were included in the study. The smears were studied to assess the differential leukocyte count and neutrophils toxic granules. Observations and Results: The age of the patients ranged from 11 to 92 years, with M:F ratio 1:1. Total leukocyte count (TLC) ranged from 1.6 to 37.3 × 109/l with a mean of 14.7 × 109/l. Absolute neutrophil count (ANC) varied from 1.31 × 109/l × to 32.4 × 109/l with a mean of 10.4 × 109/l. On peripheral smear examination, 31% of cases showed no granules in the neutrophils, 35% of cases showed scattered darkly stained granules in the cytoplasm of neutrophils (1+), 29% showed an increase in the number of granules and increase in intensity (2+), and only 5% cases showed numerous granules with increase blue–black stain. However, none of the cases showed numerous coarse granules crowing the cytoplasm (4+). Conclusion: In this study, we found that none of the single parameters, for example, the TLC and ANC, toxic granulations, and left shift are diagnostic of sepsis but all these are complementary to each other in predicting the diagnosis of sepsis.
引言:及时诊断菌血症/败血症对于开始抗菌治疗和进一步降低发病率和死亡率至关重要。目的:本研究旨在探讨中性粒细胞毒性颗粒在败血症诊断中的重要性。材料和方法:这是一项为期1年(2020年8月至2021年8月)的横断面研究。共有100例病例被纳入研究。对涂片进行研究,以评估白细胞计数和中性粒细胞毒性颗粒的差异。观察与结果:患者年龄11~92岁,男女比例1:1。总白细胞计数(TLC)范围为1.6至37.3×。中性粒细胞绝对计数(ANC)在1.31×。在外周涂片检查中,31%的病例中性粒细胞中没有颗粒,35%的病例中性白细胞细胞质中有分散的深色染色颗粒(1+),29%的病例颗粒数量增加,强度增加(2+),只有5%的病例颗粒众多,蓝黑色染色增加。然而,没有一例显示细胞质中有大量的粗颗粒(4+)。结论:在本研究中,我们发现TLC和ANC、毒性颗粒和左移等单一参数都不能诊断败血症,但所有这些参数在预测败血症诊断方面是互补的。
{"title":"Toxic granules in neutrophils in sepsis patients: Does it really helpful?","authors":"Subhash Chander, Reetika Sharma, Anuradha Sharma, Priyanka Verma","doi":"10.4103/mjmsr.mjmsr_26_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_26_22","url":null,"abstract":"Introduction: Timely diagnosis of bacteremia/sepsis is essential for the initiation of antimicrobial therapy and further reducing morbidity and mortality. Aims and Objective: This study is undertaken to find out the importance of toxic granulations in neutrophils in the diagnosis of sepsis. Materials and Methods: This was a cross-sectional type of study which was carried out for 1 year (August 2020 to August 2021). A total of 100 cases were included in the study. The smears were studied to assess the differential leukocyte count and neutrophils toxic granules. Observations and Results: The age of the patients ranged from 11 to 92 years, with M:F ratio 1:1. Total leukocyte count (TLC) ranged from 1.6 to 37.3 × 109/l with a mean of 14.7 × 109/l. Absolute neutrophil count (ANC) varied from 1.31 × 109/l × to 32.4 × 109/l with a mean of 10.4 × 109/l. On peripheral smear examination, 31% of cases showed no granules in the neutrophils, 35% of cases showed scattered darkly stained granules in the cytoplasm of neutrophils (1+), 29% showed an increase in the number of granules and increase in intensity (2+), and only 5% cases showed numerous granules with increase blue–black stain. However, none of the cases showed numerous coarse granules crowing the cytoplasm (4+). Conclusion: In this study, we found that none of the single parameters, for example, the TLC and ANC, toxic granulations, and left shift are diagnostic of sepsis but all these are complementary to each other in predicting the diagnosis of sepsis.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43943726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Human papilloma virus-related oral and oropharyngeal squamous cell carcinoma: An assessment of histomorphological features 人乳头状瘤病毒相关的口腔和口咽鳞状细胞癌:组织形态学特征的评估
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_64_22
Anasuya Lenka, U. Ghosh, D. Mohapatra, R. Tripathy
Background: Human papillomavirus (HPV) has emerged as an important cause of oral and oropharyngeal squamous cell carcinomas (OSCC and OPSCC). Cancers with HPV as a causative agent are seen to exhibit certain specific histomorphological features. Aim: This study aims to describe the histomorphology of oral and oropharyngeal cancers and discuss their association with HPV. Material and Methods: Hospital-based prospective study done over 31 months (December 2018–April 2021), including a total of 90 cases of OSCC and OPSCC. They were subjected to detailed histopathological evaluation, DNA polymerase chain reaction testing for testing of HPV association, followed by the analysis of data by statistical methods. Results: Out of a total of 90, 73 cases were OSCC and 17, OPSCC. A total of 15 cases were HPV positive. HPV status was found to be significantly associated with purely nonkeratinizing tumors and hybrid/mixed squamous cell carcinomas, pushing the pattern of invasion, absence of perineural invasion, presence of tumor infiltrating lymphocytes, moderate-to-dense host lymphocyte response, loose stromal response, absence of tumor budding, and high mitotic rate (>20/10 hpf). Conclusion: HPV-positive OSCC and OPSCC have distinct histomorphological features and careful analysis of the same can assist in identifying these types of cancers better and thus help in prognostication and treatment.
背景:人乳头瘤病毒(HPV)已成为口腔和口咽鳞状细胞癌(OSCC和OPSCC)的重要病因。以HPV为病原体的癌症表现出某些特定的组织形态学特征。目的:本研究旨在描述口腔癌和口咽癌的组织形态学,并讨论它们与HPV的关系。材料和方法:在31个月(2018年12月至2021年4月)内进行的基于医院的前瞻性研究,包括总共90例OSCC和OPSCC。他们接受了详细的组织病理学评估,DNA聚合酶链式反应检测HPV相关性,然后通过统计方法分析数据。结果:90例中,OSCC 73例,OPSCC 17例。共有15例HPV阳性。发现HPV状态与纯非角化肿瘤和混合/混合鳞状细胞癌显著相关,推动侵袭模式、无神经侵袭、存在肿瘤浸润淋巴细胞、中等至致密宿主淋巴细胞反应、疏松基质反应、无肿瘤出芽和高有丝分裂率(>20/10 hpf)。结论:HPV阳性OSCC和OPSCC具有明显的组织形态学特征,仔细分析其组织形态学特征有助于更好地识别这些类型的癌症,从而有助于预测和治疗。
{"title":"Human papilloma virus-related oral and oropharyngeal squamous cell carcinoma: An assessment of histomorphological features","authors":"Anasuya Lenka, U. Ghosh, D. Mohapatra, R. Tripathy","doi":"10.4103/mjmsr.mjmsr_64_22","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_64_22","url":null,"abstract":"Background: Human papillomavirus (HPV) has emerged as an important cause of oral and oropharyngeal squamous cell carcinomas (OSCC and OPSCC). Cancers with HPV as a causative agent are seen to exhibit certain specific histomorphological features. Aim: This study aims to describe the histomorphology of oral and oropharyngeal cancers and discuss their association with HPV. Material and Methods: Hospital-based prospective study done over 31 months (December 2018–April 2021), including a total of 90 cases of OSCC and OPSCC. They were subjected to detailed histopathological evaluation, DNA polymerase chain reaction testing for testing of HPV association, followed by the analysis of data by statistical methods. Results: Out of a total of 90, 73 cases were OSCC and 17, OPSCC. A total of 15 cases were HPV positive. HPV status was found to be significantly associated with purely nonkeratinizing tumors and hybrid/mixed squamous cell carcinomas, pushing the pattern of invasion, absence of perineural invasion, presence of tumor infiltrating lymphocytes, moderate-to-dense host lymphocyte response, loose stromal response, absence of tumor budding, and high mitotic rate (>20/10 hpf). Conclusion: HPV-positive OSCC and OPSCC have distinct histomorphological features and careful analysis of the same can assist in identifying these types of cancers better and thus help in prognostication and treatment.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42309265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical profile of term neonates requiring intervention for hyperbilirubinemia 需要干预的足月新生儿高胆红素血症的临床概况
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_83_22
A. Lobo, S. Shanbhag, Saritha Paul
Introduction: Neonatal jaundice is the imbalance between bilirubin production and conjugation, resulting in increased serum bilirubin levels. It is visible in the skin and eyes, only when the total serum bilirubin level exceeds 5–7 mg/dl. Sixty percent of the term and almost 80% of the preterm babies develop neonatal jaundice. Objectives: To identify the etiology of neonatal hyperbilirubinemia in term neonates and to determine short-term outcomes in terms of rebound hyperbilirubinemia during hospital stay and other modalities of intervention in these babies. Methods: We did a cross-sectional, descriptive, and retrospective chart-based study. The clinical profile of term neonates treated for hyperbilirubinemia was procured from the inpatient medical records and neonatal intensive care unit (NICU) discharge summaries over 5 years from January 2017 to December 2021. Short-term outcomes, such as duration of hospital stay, rebound hyperbilirubinemia, and other modalities of treatment used, were noted. Results: A total of 252 term babies who fulfilled the inclusion criteria were included in the study. Two hundred and thirty-four babies were delivered vaginally, 10 by cesarean section, and 8 extracted by instrumental delivery. Ninety-eight babies had ABO incompatibility and 19 Rh incompatibility. Twelve babies had elevated cord thyroid-stimulating hormone levels. Seventy-one babies had signs of bilirubin encephalopathy. Thirty-nine babies had sepsis. Fifty-three of them had significant weight loss suggestive of improper feeding. Thirty-three babies had cephalhematoma. Nine babies were born to mothers with gestational diabetes mellitus. All 252 babies underwent phototherapy. Thirty-two babies required a prolonged hospital stay of more than 1 week and seven had rebound hyperbilirubinemia. Nine babies required exchange transfusion. Two received intravenous immunoglobulin. Conclusions: The most common risk factor associated was ABO incompatibility, followed by inadequate breastfeeding. As only nine neonates required exchange transfusion, early and prompt initiation of phototherapy remains the best modality of treatment. Emphasis on proper feeding technique can go a long way in preventing admission to NICU, as it is the second-most common preventable cause of hyperbilirubinemia.
引言:新生儿黄疸是胆红素产生和结合之间的失衡,导致血清胆红素水平升高。只有当血清总胆红素水平超过5–7 mg/dl时,它才在皮肤和眼睛中可见。60%的足月婴儿和近80%的早产儿出现新生儿黄疸。目的:确定足月新生儿高胆红素血症的病因,并确定住院期间反弹性高胆红红素血症和其他干预方式的短期结果。方法:我们进行了一项基于横断面、描述性和回顾性图表的研究。接受高胆红素血症治疗的足月新生儿的临床资料来自2017年1月至2021年12月5年的住院病历和新生儿重症监护室(NICU)出院总结。注意到短期结果,如住院时间、高胆红素血症反弹和使用的其他治疗方式。结果:共有252名符合纳入标准的足月婴儿被纳入研究。234名婴儿通过阴道分娩,10名通过剖宫产分娩,8名通过器械分娩分娩。98名婴儿ABO血型不合,19名Rh血型不合。12名婴儿脐带促甲状腺激素水平升高。71名婴儿出现胆红素脑病症状。39名婴儿患有败血症。其中五十三只体重显著下降,提示喂养不当。33名婴儿出现脑血肿。九个婴儿是由患有妊娠期糖尿病的母亲所生。252名婴儿全部接受了光疗。32名婴儿需要延长住院时间超过1周,7名婴儿出现高胆红素血症反弹。九名婴儿需要换血。两人接受了静脉注射免疫球蛋白。结论:最常见的相关危险因素是ABO血型不合,其次是母乳喂养不足。由于只有9名新生儿需要换血,尽早开始光疗仍然是最好的治疗方式。强调正确的喂养技术可以大大防止新生儿重症监护室的入院,因为它是高胆红素血症的第二常见可预防原因。
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引用次数: 0
Coronavirus disease-2019 incidence and local wind speed: Is there any association? 2019冠状病毒病发病率与当地风速:是否有关联?
Pub Date : 2023-01-01 DOI: 10.4103/mjmsr.mjmsr_28_23
B. Joob, V. Wiwanitkit
{"title":"Coronavirus disease-2019 incidence and local wind speed: Is there any association?","authors":"B. Joob, V. Wiwanitkit","doi":"10.4103/mjmsr.mjmsr_28_23","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_28_23","url":null,"abstract":"","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46126841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Muller Journal of Medical Sciences and Research
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