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Teaching clinical anatomy to medical students by flipped classroom 通过翻转课堂向医科学生教授临床解剖学
Pub Date : 2024-03-11 DOI: 10.25259/nmji_608_21
Aarti, Kamal Singh, S. Rathee
BackgroundWe aimed to introduce the flipped classroom approach for teaching clinical anatomy and to assess its perception and feasibility among medical undergraduate students.MethodsOur study included 151 MBBS students of the first professional. We took written informed consent after the study was approved by the Ethics Committee. Selected topics of clinical anatomy were taught using the flipped classroom (FCR) method. It involved pre-class, in-class and post-class activities. In pre-class activity, pre-reading material was given to the students 1 week before the class. An assignment was given 2 days before the class in the form of solving multiple- choice questions, drawing well-labelled diagrams, etc. In- class activity included a pre-test followed by a discussion of the topic in the form of problem-based questions in the class on the principle of Think–Pair–Share. Post-class activity included summarization of the topic by students in the form of a group activity followed by a feedback session. Feedback was collected using a pre-validated feedback questionnaire on Google forms. Data collected were analysed using SPSS 21.0 and Microsoft office 2010. The response to close-ended questions was expressed as percentage. Open-ended questions were analysed by grouping of qualitative responses.ResultsWe found FCR to be a feasible, interesting and necessary pedagogical tool for medical education. Most students (95%) agreed that FCR is a useful technique for better understanding of clinical anatomy. They learnt better from FCR than other teaching methods and their in-depth understanding of the topic improved with FCR.ConclusionFCR is an established teaching–learning tool but it needs to be implemented in undergraduate teaching of clinical anatomy for better understanding of the topics. Didactic lectures do not touch upon clinical correlations in a case-based manner, which can be easily discussed in FCR.
背景我们的目的是在临床解剖学教学中引入翻转课堂教学法,并评估其在医学本科生中的认知度和可行性。经伦理委员会批准后,我们获得了知情同意书。我们采用翻转课堂(FCR)方法讲授临床解剖学的选定主题。其中包括课前、课中和课后活动。在课前活动中,预习材料在上课前一周发给学生。课前 2 天布置作业,形式包括解答选择题、绘制标注清楚的图表等。课上活动包括预测试,然后根据 "思考--对子--分享 "的原则,在课堂上以问题的形式讨论主题。课后活动包括学生以小组活动的形式对主题进行总结,然后进行反馈。反馈是通过谷歌表格上预先验证的反馈问卷收集的。收集到的数据使用 SPSS 21.0 和 Microsoft office 2010 进行分析。对封闭式问题的答复以百分比表示。结果我们发现,FCR 是一种可行、有趣且必要的医学教育教学工具。大多数学生(95%)都认为 FCR 是一种有助于更好地理解临床解剖学的有用技术。结论FCR是一种成熟的教学工具,但需要在临床解剖学本科教学中加以实施,以便更好地理解相关主题。说教式授课无法以案例为基础的方式触及临床相关性,而在 FCR 中可以很容易地讨论这些问题。
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引用次数: 0
Reducing the Risks of Nuclear War: The role of health professionals 降低核战争风险:卫生专业人员的作用
Pub Date : 2024-03-11 DOI: 10.25259/nmji_687_2023
K. Abbasi, P. Ali, V. Barbour, K. Bibbins-Domingo, M. Rikkert, Andy Haines, Ira Helfand, A. Mitra, Tilman Ruff, R. Horton, Bob Mash, C. Monteiro, E. Naumova, Eric J Rubin, P. Sahni, J. Tumwine, P. Yonga, C. Zielinski
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引用次数: 0
Reticular epithelial corneal oedema secondary to topical netarsudil drops 网状上皮角膜水肿继发于外用奈达胂滴眼液
Pub Date : 2024-03-11 DOI: 10.25259/nmji_675_22
Vijayalakshmi Senthil Kumar, G. Puthuran, Naveen Radhakrishnan, Piyush Kohli
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引用次数: 0
Correlates of loneliness and dissatisfaction following SARS pandemic lockdown: Child and parent perspective 非典大流行封锁后孤独和不满的相关因素:儿童和家长的观点
Pub Date : 2024-03-11 DOI: 10.25259/nmji_303_21
Rajni Sharma, Babita Ghai, Lokesh Saini, Aditi Jain, Krishan Kumar, Rubinderjit Singh Brar, Shubh Mohan Singh, Vikas Suri, Jaivinder Yadav, Ritin Mohindra, Nitin Gupta
BackgroundStudying loneliness among children is important because it causes much social pain and is considered to be a risk factor for many mental and physical problems.MethodsWe did an online survey between July and September 2020 among students and their parents from a cluster of government and private schools chosen from north, south, east and west of Chandigarh. The survey consisted of child and parent versions of the Loneliness and Social Dissatisfaction Questionnaire, Parent–Child Relationship (PCR) Questionnaire and Conflict Behaviour Questionnaire SF. Parental distress was assessed using the Depression, Anxiety and Stress Scale-21.ResultsThe majority of children and parent participants reported high loneliness and dissatisfaction among children. A significant positive association was found between children and parent reported loneliness and dissatisfaction, and between child reported PCR and parent perception of PCR. A child’s appraisal of her loneliness had a significant negative association with depression among parents. Parent’s perception of child loneliness and dissatisfaction was negatively associated with PCR and parental anxiety. High loner boys reported poor quality of relationship and more conflicts with their parents than girls. Children who share cordial relations with their parents had fewer conflicts and also scored low on loneliness.ConclusionThese results suggest that the issue of loneliness and dissatisfaction among children has attained epidemic proportions in the Covid-19 era, and active interventions are needed to safeguard the mental health of children. Our study emphasizes the need to plan guidance strategies with a joint effort of schools and families to strengthen within family relations of children.
背景研究儿童的孤独感非常重要,因为它会造成许多社会痛苦,并被认为是许多心理和生理问题的风险因素。方法我们在 2020 年 7 月至 9 月期间对来自昌迪加尔北部、南部、东部和西部的一组公立和私立学校的学生及其家长进行了在线调查。调查包括儿童和家长版本的孤独和社会不满意度问卷、亲子关系(PCR)问卷和冲突行为问卷 SF。结果大多数儿童和家长都表示,儿童的孤独感和不满情绪很高。在儿童和家长报告的孤独感和不满意度之间,以及儿童报告的 PCR 和家长对 PCR 的看法之间,发现了明显的正相关。孩子对自己孤独感的评价与家长的抑郁情绪有明显的负相关。家长对孩子孤独和不满意的感知与 PCR 和家长焦虑呈负相关。与女孩相比,高度孤独的男孩与父母的关系质量较差,冲突较多。这些结果表明,在 Covid-19 时代,儿童的孤独和不满问题已经达到了流行病的程度,需要采取积极的干预措施来保护儿童的心理健康。我们的研究强调,有必要在学校和家庭的共同努力下规划指导策略,以加强儿童的家庭内部关系。
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引用次数: 0
Blood pressure cut-offs to diagnose impending hypertensive emergency depend on previous hypertension-mediated organ damage and comorbid conditions 诊断即将发生的高血压急症的血压临界值取决于先前由高血压引发的器官损伤和合并症
Pub Date : 2024-03-11 DOI: 10.25259/nmji_160_21
Goran Koracevic, Milovan Stojanovic, D. Lovic, Tomislav Kostic, Miloje Tomasevic, S. S. Martinovic, S. C. Zdravkovic, M. Koraćević, Vladimir Stojanovic
BackgroundHypertensive emergencies (HTN-E) are important due to a high risk of mortality. However, a sudden increase in blood pressure (BP) can damage target organs before the BP reaches cut-offs to diagnose HTN-E. We (i) analyse HTN guidelines for recommendations of treatment individualization, such as adjusting BP cut-offs for hypertensive urgency or impending HTN-E according to patient’s susceptibility to complications (because of previous hypertension-mediated organ damage [HMOD], cardiovascular events and comorbid conditions), and (ii) provide a rationale for the inclusion of patient’s susceptibility in protocols for treatment of acute HTN-E.MethodsWe searched PubMed, SCOPUS, Science Direct, Springer, Oxford Press, Wiley, SAGE and Google Scholar for the following terms: arterial hypertension, impending, emergency, target organ damage, hypertension-mediated organ damage, and comorbidity.ResultsThe available guidelines do not recommend that when we estimate the probability of HTN-E in a patient with very high BP, we take into account not only the ‘aggressive factor’ (i.e. history of HTN, absolute BP values and rate of its increase), but also the ‘vulnerability of the patient’ due to previous major adverse cardio-vascular events, HMOD and comorbid conditions.ConclusionThe risk does not depend only on the aggressiveness of the health threat but also on the strength of the host’s defence. It is, therefore, surprising that one side of the natural interaction (i.e. susceptibility of a patient) is overlooked in almost all available guidelines on HTN.
背景高血压急症(HTN-E)具有很高的死亡风险,因此非常重要。然而,在血压达到诊断高血压急症的临界值之前,血压(BP)的突然升高可能会损害目标器官。我们(i)分析了高血压指南中关于治疗个体化的建议,如根据患者对并发症的易感性(由于既往高血压介导的器官损伤[HMOD]、心血管事件和合并症)调整高血压急症或即将发生的高血压急性发作的血压临界值,(ii)为将患者的易感性纳入急性高血压急性发作的治疗方案提供理论依据。方法我们在 PubMed、SCOPUS、Science Direct、Springer、Oxford Press、Wiley、SAGE 和 Google Scholar 上检索了以下术语:动脉高血压、即将发生、紧急情况、靶器官损伤、高血压介导的器官损伤和合并症。结果现有指南并不建议我们在估算血压极高患者发生高血压危象的概率时,不仅要考虑 "侵袭性因素"(即高血压病史、绝对血压值及其升高速度),还要考虑由于既往重大不良心血管事件、HMOD 和合并症而导致的 "患者脆弱性"。因此,令人惊讶的是,几乎所有现有的高血压指南都忽略了自然相互作用的一面(即患者的易感性)。
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引用次数: 0
Phaging out antibiotics 噬菌体淘汰抗生素
Pub Date : 2024-03-11 DOI: 10.25259/nmji_482_21
Varad Puntambekar
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引用次数: 0
Anxiety disorders 焦虑症
Pub Date : 2024-03-11 DOI: 10.25259/nmji_530_2022
Roopali Shivalkar, Somnath Sengupta
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引用次数: 0
Improving treatment adherence among tuberculosis patients through evening DOTS in Chennai, India 在印度钦奈通过晚间短期直接观察治疗提高肺结核患者的治疗依从性
Pub Date : 2024-03-11 DOI: 10.25259/nmji_819_20
D. Devaleenal, Lavanya Jeyabal, Dina Nair, Vasantha Mahalingam, R. R, Binny Priscilla Rebecca, Chandra Suresh, Paranchi Ramesh Murugesan, Beena Thomas
BackgroundFixed days and timings of service are challenges in the care of patients with tuberculosis (TB). We assessed whether provision of evening DOTS (directly observed treatment, short course) improves treatment outcomes in a city with a working population.MethodsWe enrolled new adult patients with TB from seven tuberculous units (TUs) in this prospective cohort study. Participants were offered the option of DOTS during the day (8 a.m. to 3:30 p.m.) or evening (4 p.m. to 8 p.m.) and assigned accordingly.ResultsOf 127 patients enrolled between April and July 2017, 19 (15%) opted for evening DOTS. The number varied between the seven TUs (p=0.002). On an average, antitubercular therapy (ATT) was taken at 9:41 a.m. in the routine and 5:14 p.m. in the evening DOTS centres. Patients who were employed, left residence and returned back at 9:05 a.m. and 6:40 p.m., respectively. Around 96% (104/108) opted for day-time DOTS due to closeness of the centre to their residence. Around 74% (14/19) chose evening DOTS because of time convenience. Around 15% of patients on routine DOTS (16) had unfavourable treatment outcomes. All had favourable outcomes in the evening DOTS. Men were less likely and those withut alcohol disorders were more likely to have treatment success.ConclusionProvision of time convenient services might improve adherence and treatment outcome.
背景固定的服务日期和时间是肺结核(TB)患者治疗过程中面临的挑战。我们评估了晚间直接观察治疗(短程直接观察治疗)是否能改善一个工作人口城市的治疗效果。参与者可选择在白天(上午 8 点至下午 3:30)或晚上(下午 4 点至晚上 8 点)接受短期直接观察治疗,并进行相应分配。结果在 2017 年 4 月至 7 月间入组的 127 名患者中,19 人(15%)选择了晚上的短期直接观察治疗。这一数字在七个治疗单位之间存在差异(P=0.002)。在常规 DOTS 中心,抗结核治疗(ATT)的平均服药时间为上午 9:41,而在晚间 DOTS 中心,服药时间为下午 5:14。有工作的患者分别在上午 9:05 和下午 6:40 离开住所并返回。约 96%(104/108)的患者选择了日间短期直接观察治疗,因为中心离他们的住所很近。约 74%(14/19)的患者因时间方便而选择晚间短期直接观察治疗。约 15%(16 人)接受常规短期直接观察治疗的患者治疗效果不佳。在晚间短期直接观察治疗中,所有患者都取得了良好的治疗效果。男性患者的治疗成功率较低,而酗酒患者的治疗成功率较高。
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引用次数: 0
Prevalence of anaemia among adolescent girls (10–19 years) in India: A systematic review and meta-analysis 印度少女(10-19 岁)的贫血患病率:系统回顾与荟萃分析
Pub Date : 2024-03-11 DOI: 10.25259/nmji_637_21
R. Daniel, Mani Kalaivani, Shashi Kant, S. Gupta
BackgroundAnaemia is a serious public health problem. It is the second-commonest contributing factor to years lost by adolescents to disability and death. Targeting adolescent girls will allow a window of opportunity to correct their nutritional health and improve their obstetric outcomes. Studies in India have reported varying prevalence rates of anaemia among adolescent girls. Hence, we did a systematic review and meta-analysis of community-based studies to obtain a comprehensive pooled estimate of the prevalence of anaemia among adolescent girls in India.Methods We did a systematic electronic search in PubMed, Embase, Cochrane Library and Google scholar to retrieve community-based studies that reported the prevalence of anaemia among adolescent girls (10–19 years) in India, without any date or language restriction. To estimate the pooled prevalence and heterogeneity, the random-effects model and I2 statistical methods were used. We did subgroup analyses based on geographical region, study setting, method used to measure haemoglobin concentration, and year of publication.Results We included 35 studies in this meta-analysis comprising 152 640 participants. The pooled prevalence of anaemia among adolescent girls was 65.7% (95% CI 59.3%– 71.9%). There was significant heterogeneity between the studies (I2 99.6%; p<0.001).Conclusion There is a high prevalence of anaemia among adolescent girls in India. While all regions of the country have a high prevalence, tribal areas need special attention. Targeted actions need to focus on the identification of determinants of anaemia apart from iron supplementation.
背景贫血是一个严重的公共卫生问题。它是导致青少年残疾和死亡的第二大常见因素。针对少女的治疗将为纠正她们的营养健康状况和改善她们的产科预后提供机会。印度的研究报告显示,少女的贫血患病率各不相同。我们在 PubMed、Embase、Cochrane 图书馆和谷歌学者中进行了系统的电子检索,检索了报告印度少女(10-19 岁)贫血患病率的社区研究,没有任何日期或语言限制。为了估算总体患病率和异质性,我们采用了随机效应模型和 I2 统计方法。我们根据地理区域、研究环境、测量血红蛋白浓度的方法和发表年份进行了分组分析。汇总的少女贫血患病率为 65.7%(95% CI 59.3%- 71.9%)。结论 印度少女的贫血患病率很高。虽然印度所有地区的发病率都很高,但部落地区需要特别关注。除了补充铁质外,还需要采取有针对性的行动,重点确定贫血的决定因素。
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引用次数: 0
The Australian Medical Journal, August 1846 澳大利亚医学杂志》,1846 年 8 月
Pub Date : 2024-03-11 DOI: 10.25259/nmji_826_2023
R. Raman, A. Raman
Medical journals started appearing formally in Europe in the 17th century and in North America in the 18th century. In Australia, the first issue of Australian Medical Journal (AMJ) was issued in Sydney, under the stewardship of a New South Wales (NSW) senior surgeon William Brooks working in Newcastle (NSW) in August 1846. This article refers to that issue of AMJ exploring its contents and context. In terms of original articles, only one on the surgical procedures carried out on two patients suffering strangulated hernias in the Parramatta-Public Hospital by Surgeon Thomas Robertson occurs. The other inclusions are précis from contemporary British medical journals. The AMJ appeared only for a year; why it ceased publication in 1847 is not clear. It was resurrected by the Medical Society of Victoria, Melbourne in 1856, issuing 40 annual volumes uninterruptedly until 1895. With the incorporation of other regional Australian medical journals, AMJ was re-named as the Medical Journal of Australia (MJA) in 1914. As MJA, it continues to perform to-date. Natl Med J India 2023;36:263–8
17 世纪和 18 世纪,医学期刊分别在欧洲和北美开始正式出现。在澳大利亚,第一期《澳大利亚医学杂志》(AMJ)于 1846 年 8 月在悉尼发行,由在纽卡斯尔(新南威尔士州)工作的新南威尔士州高级外科医生威廉-布鲁克斯(William Brooks)负责管理。本文对该期《医学杂志》的内容和背景进行了探讨。在原创文章方面,只有一篇是关于外科医生托马斯-罗伯逊(Thomas Robertson)在帕拉马塔公立医院对两名患有绞窄性疝气的病人进行手术治疗的文章。其他文章均为当代英国医学期刊的摘要。AMJ 只出版了一年,1847 年停刊的原因尚不清楚。1856 年,墨尔本维多利亚医学会恢复了该杂志,直到 1895 年,该杂志每年发行 40 卷,从未间断。随着澳大利亚其他地区医学期刊的合并,《澳大利亚医学杂志》于 1914 年更名为《澳大利亚医学杂志》(MJA)。作为 MJA,它一直延续至今。印度国家医学杂志》2023;36:263-8
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引用次数: 0
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The National Medical Journal of India
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