Becki Varghese, Ajay Wahi, G. Duggal, S. Bansal, Prabhdeep Singh, Manvi Garg
Introduction: Spinal anesthesia is one of the most commonly used techniques in modern anesthesia. Spinal needles have evolved over time to increase efficacy and decrease complications. Fine gauge spinal needles technically consume more time but are advisable in certain clinical conditions such as raised intracranial pressure and when patient well-being and comfort are the priorities. Hence, we undertook this study to compare the effects and complication of transverse insertion of Quincke's spinal needle 26 G (gauge) and 29 G. Materials and Methods: Hundred patients of age 18–40 years posted for lower abdominal and lower limb surgeries were allocated into two groups of 50 each to receive spinal anesthesia with 3 ml of 0.5% bupivacaine using 26 G or 29 G Quincke's spinal needle. All the patients were evaluated for the time of drug administration, number of attempts, time to attain sensory blockade up to T8 level, time to attain motor blockade up to bromage Grade 3, and incidence of post-dural puncture headache (PDPH) and post-dural puncture backache. Results: Demographic data were comparable in both groups. The PDPH incidence on 3rd day for 29 G Quincke's was 0% while for 26 G Quincke's was 12%. There was statistically significant difference when 26 G Quincke's was compared with 29 G Quincke's for number of attempts, time of drug administration, time to attain motor and sensory block. Conclusion: 29 G Quincke's spinal could be used to provide spinal anesthesia in young adult patients owing to adequate sensory and motor blockade with no incidence of PDPH and backache.
导读:脊髓麻醉是现代麻醉中最常用的技术之一。随着时间的推移，脊髓针已经发展到提高疗效和减少并发症。细径脊髓针在技术上消耗更多的时间，但在某些临床条件下是可取的，例如颅内压升高，以及当患者的健康和舒适是优先考虑的。因此，我们进行了这项研究，比较26g (gauge)和29g (29g)昆克脊髓针横向插入的效果和并发症。材料和方法:将100例18-40岁的下腹部和下肢手术患者分为两组，每组50人，分别使用26g或29g昆克脊髓针接受3ml 0.5%布比卡因的脊髓麻醉。评估所有患者的给药时间、尝试次数、达到T8级的感觉阻断时间、达到bromage 3级的运动阻断时间、硬膜穿刺后头痛(PDPH)和硬膜穿刺后背痛的发生率。结果:两组人口统计学数据具有可比性。29 G Quincke的第3天PDPH发生率为0%，26 G Quincke的第3天PDPH发生率为12%。26 G Quincke组与29 G Quincke组在尝试次数、给药时间、达到运动和感觉阻滞时间等方面比较，差异均有统计学意义。结论:29 G Quincke脊髓可用于青壮年患者的脊髓麻醉，其感觉和运动阻滞充分，且无PDPH和背痛的发生。
{"title":"Comparative study on the effects and complications of transverse insertion of two fine gauge quincke's spinal needles 26 and 29 G in spinal anesthesia","authors":"Becki Varghese, Ajay Wahi, G. Duggal, S. Bansal, Prabhdeep Singh, Manvi Garg","doi":"10.4103/amit.amit_11_23","DOIUrl":"https://doi.org/10.4103/amit.amit_11_23","url":null,"abstract":"Introduction: Spinal anesthesia is one of the most commonly used techniques in modern anesthesia. Spinal needles have evolved over time to increase efficacy and decrease complications. Fine gauge spinal needles technically consume more time but are advisable in certain clinical conditions such as raised intracranial pressure and when patient well-being and comfort are the priorities. Hence, we undertook this study to compare the effects and complication of transverse insertion of Quincke's spinal needle 26 G (gauge) and 29 G. Materials and Methods: Hundred patients of age 18–40 years posted for lower abdominal and lower limb surgeries were allocated into two groups of 50 each to receive spinal anesthesia with 3 ml of 0.5% bupivacaine using 26 G or 29 G Quincke's spinal needle. All the patients were evaluated for the time of drug administration, number of attempts, time to attain sensory blockade up to T8 level, time to attain motor blockade up to bromage Grade 3, and incidence of post-dural puncture headache (PDPH) and post-dural puncture backache. Results: Demographic data were comparable in both groups. The PDPH incidence on 3rd day for 29 G Quincke's was 0% while for 26 G Quincke's was 12%. There was statistically significant difference when 26 G Quincke's was compared with 29 G Quincke's for number of attempts, time of drug administration, time to attain motor and sensory block. Conclusion: 29 G Quincke's spinal could be used to provide spinal anesthesia in young adult patients owing to adequate sensory and motor blockade with no incidence of PDPH and backache.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"112 1","pages":"29 - 33"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79632503","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}
Zeeshan Iqbal, S. Rana, S. Khetrapal, Monal Trisal, N. Ahmed, S. Jetley, Arun Sharma, Z. Jairajpuri
Introduction: Salivary gland neoplasms are uncommon tumors comprising <3%–10% of all head-and-neck neoplasms. Recent WHO classification of salivary gland tumor added many newer entities; however, no definite risk-stratification system is specified to predict the likelihood of malignancy for each diagnostic category. The present study is designed to evaluate the salivary gland aspirates using the Milan System for Reporting Salivary Gland Cytology for reporting correlating with histological diagnosis which will lead to determine the malignancy risk for each diagnostic category. Risk of malignancy is calculated by the ratio of cytopathology cases with a malignant histopathology to the total number of cytopathology cases with follow-up histopathology for that particular category. Materials and Methods: The present study was a cross-sectional study done prospectively over a period of 2 years, and a total of 72 participants were selected. This study characterized the cytological features of spectrum of salivary gland lesions varying from benign to malignant. The lesions were evaluated and classified cytologically according to “the Milan System for Reporting Salivary Gland Cytopathology” for reporting salivary gland neoplasms. Histopathological correlation was done with cytological diagnosis wherever possible. Results: In our study of 72 patients with salivary gland lesions with the mean age of the patient being 50.6 years and maximum number of lesions involved the parotid gland followed by the submandibular gland and sublingual gland. Majority of the lesions in the present study were nonneoplastic in nature followed by lesions benign in nature. Malignant lesions were least common in occurrence. Among 72 cases, majority of the cases were seen in Milan category II (nonneoplastic) consisting of 34 cases (47.2%), followed by 31 cases (43.1%) in Milan category IV (benign). Final diagnostic categorization of 72 cases of salivary gland lesions was done according to the Milan system and the histopathological correlation was available in 23 of these cases. Out of the 34 cases in Milan system category II (nonneoplastic), histopathological evaluation was done in 2 cases. Both the cases were benign in nature, 31 cases in Milan system category IV (benign) histopathological evaluation was done in 16 cases where 15 cases were benign in nature and 1 lesion was malignant. Four cases were put in category VI of the Milan system, histopathological evaluation was done in all the 4 cases which were all malignant in nature. Conclusion: The current study validates fine-needle aspiration cytology as a cost-effective and noninvasive procedure for differentiating between benign and malignant lesions of the salivary gland, information of critical importance when determining the patient's next course of treatment.
{"title":"Application of the milan system for reporting salivary gland cytology and risk stratification by cytohistological correlation","authors":"Zeeshan Iqbal, S. Rana, S. Khetrapal, Monal Trisal, N. Ahmed, S. Jetley, Arun Sharma, Z. Jairajpuri","doi":"10.4103/amit.amit_28_23","DOIUrl":"https://doi.org/10.4103/amit.amit_28_23","url":null,"abstract":"Introduction: Salivary gland neoplasms are uncommon tumors comprising <3%–10% of all head-and-neck neoplasms. Recent WHO classification of salivary gland tumor added many newer entities; however, no definite risk-stratification system is specified to predict the likelihood of malignancy for each diagnostic category. The present study is designed to evaluate the salivary gland aspirates using the Milan System for Reporting Salivary Gland Cytology for reporting correlating with histological diagnosis which will lead to determine the malignancy risk for each diagnostic category. Risk of malignancy is calculated by the ratio of cytopathology cases with a malignant histopathology to the total number of cytopathology cases with follow-up histopathology for that particular category. Materials and Methods: The present study was a cross-sectional study done prospectively over a period of 2 years, and a total of 72 participants were selected. This study characterized the cytological features of spectrum of salivary gland lesions varying from benign to malignant. The lesions were evaluated and classified cytologically according to “the Milan System for Reporting Salivary Gland Cytopathology” for reporting salivary gland neoplasms. Histopathological correlation was done with cytological diagnosis wherever possible. Results: In our study of 72 patients with salivary gland lesions with the mean age of the patient being 50.6 years and maximum number of lesions involved the parotid gland followed by the submandibular gland and sublingual gland. Majority of the lesions in the present study were nonneoplastic in nature followed by lesions benign in nature. Malignant lesions were least common in occurrence. Among 72 cases, majority of the cases were seen in Milan category II (nonneoplastic) consisting of 34 cases (47.2%), followed by 31 cases (43.1%) in Milan category IV (benign). Final diagnostic categorization of 72 cases of salivary gland lesions was done according to the Milan system and the histopathological correlation was available in 23 of these cases. Out of the 34 cases in Milan system category II (nonneoplastic), histopathological evaluation was done in 2 cases. Both the cases were benign in nature, 31 cases in Milan system category IV (benign) histopathological evaluation was done in 16 cases where 15 cases were benign in nature and 1 lesion was malignant. Four cases were put in category VI of the Milan system, histopathological evaluation was done in all the 4 cases which were all malignant in nature. Conclusion: The current study validates fine-needle aspiration cytology as a cost-effective and noninvasive procedure for differentiating between benign and malignant lesions of the salivary gland, information of critical importance when determining the patient's next course of treatment.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"112 5 1","pages":"65 - 70"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83635454","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}
Gurbax Singh, P. Jolly, Sumit Prinja, A. S. Bawa, A. Vignesh
Introduction: Adenoidectomy is currently considered the treatment of choice for relief of the nasal airway obstruction due to adenoid hypertrophy. Evidence suggests that topical nasal steroid sprays can cause a reduction in adenoid size. We aim to compare the effectiveness of fluticasone propionate, mometasone furoate (MF) and saline nasal sprays in relieving the signs and symptoms of adenoid hypertrophy and in reducing the size of the adenoids. Materials and Methods: We conducted a randomized comparative study on 60 patients divided into three groups A, B, C (20 each). Group A patients treated with fluticasone propionate nasal spray (400 μg/day), Group B patients treated with MF nasal spray (100 μg/day), and Group C patients treated with saline spray (0.65% w/v in purified water which is made isotonic and buffered). Treatment was given up to 12 weeks with follow-up at 4, 8, and 12 weeks and at each follow-up visit assessment was done. Final data were analyzed using SPSS software version 21 and numerical variables associated with different groups were analyzed and analysis of variance test was used. Results: Diagnostic nasal endoscopy and X-ray grades at day 1 among the study groups were not statistically significant, whereas, at 12 weeks results among fluticasone and mometasone groups were significantly better (P < 0.001) as compared to the saline group. There was a significant improvement in the symptoms under all the categories with the use of fluticasone and mometasone. Conclusion: In our study, both fluticasone propionate and MF were able to effectively reduce symptoms and signs of adenoid hypertrophy as well as help in reducing the size of the enlarged adenoid. Both these drugs were well tolerated by the patients.
{"title":"A comparative study of fluticasone propionate, mometasone furoate, and saline nasal spray in the treatment of children with adenoid hypertrophy}","authors":"Gurbax Singh, P. Jolly, Sumit Prinja, A. S. Bawa, A. Vignesh","doi":"10.4103/amit.amit_38_23","DOIUrl":"https://doi.org/10.4103/amit.amit_38_23","url":null,"abstract":"Introduction: Adenoidectomy is currently considered the treatment of choice for relief of the nasal airway obstruction due to adenoid hypertrophy. Evidence suggests that topical nasal steroid sprays can cause a reduction in adenoid size. We aim to compare the effectiveness of fluticasone propionate, mometasone furoate (MF) and saline nasal sprays in relieving the signs and symptoms of adenoid hypertrophy and in reducing the size of the adenoids. Materials and Methods: We conducted a randomized comparative study on 60 patients divided into three groups A, B, C (20 each). Group A patients treated with fluticasone propionate nasal spray (400 μg/day), Group B patients treated with MF nasal spray (100 μg/day), and Group C patients treated with saline spray (0.65% w/v in purified water which is made isotonic and buffered). Treatment was given up to 12 weeks with follow-up at 4, 8, and 12 weeks and at each follow-up visit assessment was done. Final data were analyzed using SPSS software version 21 and numerical variables associated with different groups were analyzed and analysis of variance test was used. Results: Diagnostic nasal endoscopy and X-ray grades at day 1 among the study groups were not statistically significant, whereas, at 12 weeks results among fluticasone and mometasone groups were significantly better (P < 0.001) as compared to the saline group. There was a significant improvement in the symptoms under all the categories with the use of fluticasone and mometasone. Conclusion: In our study, both fluticasone propionate and MF were able to effectively reduce symptoms and signs of adenoid hypertrophy as well as help in reducing the size of the enlarged adenoid. Both these drugs were well tolerated by the patients.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"80 1","pages":"59 - 64"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88580758","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}
Introduction: Guided imagery (GI) is a mind–body intervention, in which individuals generate mental images of pleasant objects or events in their minds. These mental images produce positivity and alter the perception of headaches and other pain disorders. A review of literature suggests that GI is an effective psychological treatment for tension-type headache (TTH) and state-trait anxiety. Hence, the present study aimed to assess the efficacy of GI on TTH associated with state-trait anxiety and to compare its efficacy with treatment as usual (TAU). Materials and Methods: Forty treatment-naïve patients diagnosed with TTH were selected from the psychiatry outpatient department through purposive sampling method. The Henry Ford Hospital Headache Disability Inventory and the State-Trait Anxiety Inventory for Adults were administered on all the patients for baseline data. Experimental group (n = 20) were given eight sessions of GI along with TAU for 2 months, whereas waitlist group (n = 20) were given only TAU. Results: A Significant positive association was obtained between emotional and functional disability of headache and state-trait anxiety at baseline. Postassessment findings demonstrated a significant reduction in severity and frequency of TTH, emotional and functional disability, and state-trait anxiety in the experimental group receiving GI as compared to the waitlist group. Conclusion: Patients living with TTH more commonly suffer from state-trait anxiety. Those patients who were given GI along with TAU for 2 months improved on severity and frequency of TTH, emotional and functional disability of TTH, and state-trait anxiety more effectively than those patients receiving only TAU. Consequently, it can be said that GI is an effective treatment for TTH and state-trait anxiety as compared to TAU.
{"title":"Guided imagery intervention for the treatment of tension-type headache associated with state-trait anxiety","authors":"Kehksha","doi":"10.4103/amit.amit_80_21","DOIUrl":"https://doi.org/10.4103/amit.amit_80_21","url":null,"abstract":"Introduction: Guided imagery (GI) is a mind–body intervention, in which individuals generate mental images of pleasant objects or events in their minds. These mental images produce positivity and alter the perception of headaches and other pain disorders. A review of literature suggests that GI is an effective psychological treatment for tension-type headache (TTH) and state-trait anxiety. Hence, the present study aimed to assess the efficacy of GI on TTH associated with state-trait anxiety and to compare its efficacy with treatment as usual (TAU). Materials and Methods: Forty treatment-naïve patients diagnosed with TTH were selected from the psychiatry outpatient department through purposive sampling method. The Henry Ford Hospital Headache Disability Inventory and the State-Trait Anxiety Inventory for Adults were administered on all the patients for baseline data. Experimental group (n = 20) were given eight sessions of GI along with TAU for 2 months, whereas waitlist group (n = 20) were given only TAU. Results: A Significant positive association was obtained between emotional and functional disability of headache and state-trait anxiety at baseline. Postassessment findings demonstrated a significant reduction in severity and frequency of TTH, emotional and functional disability, and state-trait anxiety in the experimental group receiving GI as compared to the waitlist group. Conclusion: Patients living with TTH more commonly suffer from state-trait anxiety. Those patients who were given GI along with TAU for 2 months improved on severity and frequency of TTH, emotional and functional disability of TTH, and state-trait anxiety more effectively than those patients receiving only TAU. Consequently, it can be said that GI is an effective treatment for TTH and state-trait anxiety as compared to TAU.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"150 1","pages":"141 - 146"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74430869","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}
B. Soumya, D. Rajalakshmi, S. Kulkarni, R. Devi, V. Kulkarni
Introduction: Clinically, all trophoblastic lesions are frequently combined under a broad spectrum of gestational trophoblastic diseases (GTDs) without the use of specific pathological terms. However, studies now demonstrate that various forms of GTDs demonstrate differences in etiology, histogenesis, morphology, and clinical behavior. Thus, the need for diagnostic histopathology of these lesions to distinguish gestational trophoblastic neoplasms from nonneoplastic lesions and molar pregnancies and also for early anticipation for early anticipation, risk category stratification, prognostication, management, and prediction of persistent GTD. Our study aimed to study the histomorphological patterns of various types of GTD with light microscopy and the pattern of occurrence of GTDs in relation to age, parity, and gestation. Materials and Methods: The present study was conducted in the department of pathology, from January 2020 to April 2022. All GTDs confirmed by histopathological examination by hematoxylin- and eosin-stained slides were included. Results: The spectrum of GTDs found in this study was seventy cases of hydatidiform mole (92.10%), three cases of exaggerated placental site (EPS) reaction (3.94%), and two cases of choriocarcinoma (2.63%) and one case (1.31%) of placental site trophoblastic tumor (PSTT). The most common presenting symptom was vaginal bleeding (93.42%). Conclusion: Hydatidiform mole forms the most common type of GTD with an incidence of complete moles more than partial moles. Histomorphological examination and analysis are helpful for confirmatory diagnosis. The most common clinical presentation of GTD was vaginal bleeding followed by amenorrhea. Emphasis on detailed descriptive morphological assessment can help in the histological distinction of benign lesions such as EPS reaction and placental site nodule and avert such cases from being erroneously diagnosed as neoplastic. The Ki-67 proliferation index helped in distinguishing the EPS reaction from neoplastic lesions such as PSTT which requires surgical intervention and chemotherapy.
{"title":"Histomorphological analysis of gestational trophoblastic disease spectrum with clinicopathological correlation at a teaching hospital","authors":"B. Soumya, D. Rajalakshmi, S. Kulkarni, R. Devi, V. Kulkarni","doi":"10.4103/amit.amit_84_22","DOIUrl":"https://doi.org/10.4103/amit.amit_84_22","url":null,"abstract":"Introduction: Clinically, all trophoblastic lesions are frequently combined under a broad spectrum of gestational trophoblastic diseases (GTDs) without the use of specific pathological terms. However, studies now demonstrate that various forms of GTDs demonstrate differences in etiology, histogenesis, morphology, and clinical behavior. Thus, the need for diagnostic histopathology of these lesions to distinguish gestational trophoblastic neoplasms from nonneoplastic lesions and molar pregnancies and also for early anticipation for early anticipation, risk category stratification, prognostication, management, and prediction of persistent GTD. Our study aimed to study the histomorphological patterns of various types of GTD with light microscopy and the pattern of occurrence of GTDs in relation to age, parity, and gestation. Materials and Methods: The present study was conducted in the department of pathology, from January 2020 to April 2022. All GTDs confirmed by histopathological examination by hematoxylin- and eosin-stained slides were included. Results: The spectrum of GTDs found in this study was seventy cases of hydatidiform mole (92.10%), three cases of exaggerated placental site (EPS) reaction (3.94%), and two cases of choriocarcinoma (2.63%) and one case (1.31%) of placental site trophoblastic tumor (PSTT). The most common presenting symptom was vaginal bleeding (93.42%). Conclusion: Hydatidiform mole forms the most common type of GTD with an incidence of complete moles more than partial moles. Histomorphological examination and analysis are helpful for confirmatory diagnosis. The most common clinical presentation of GTD was vaginal bleeding followed by amenorrhea. Emphasis on detailed descriptive morphological assessment can help in the histological distinction of benign lesions such as EPS reaction and placental site nodule and avert such cases from being erroneously diagnosed as neoplastic. The Ki-67 proliferation index helped in distinguishing the EPS reaction from neoplastic lesions such as PSTT which requires surgical intervention and chemotherapy.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"155 1","pages":"147 - 152"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77127700","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}
Adwitiya Das, M. Datta, S. Banerjee, Soumitra Mondal
Introduction: Workplace violence (WPV) toward health-care workers is increasing. The present study aims to estimate the proportion of resident doctors and interns of a tertiary care hospital who experienced WPV, to find out the perpetrators of WPV, and to ascertain any association between WPV and work-related stress. Materials and Methods: This observational, institution-based, cross-sectional study included resident doctors and interns working in six different departments of a tertiary care hospital. Data collection was done using a predesigned, pretested semi-structured self-administered questionnaire adapted and validated from the "WPV in the health sector survey questionnaire" from WHO along with "Perceived occupational stress scale." Results: Out of 323 participants, 247 (76.47%) experienced some form of WPV, 138 (42.72%) experienced physical violence and 203 (62.85%) experienced psychological violence. Patient relatives were reported as the only perpetrators of physical violence, while seniors of the study subjects were reported as main perpetrators of psychological violence. One hundred and thirty-four (42%) individuals reported work-related stress. On multivariate analysis, psychological violence was significantly associated with work-related stress. Conclusion: WPV was experienced by a high proportion of study subjects. Psychological violence was more frequently experienced, and senior colleagues were deemed responsible in most cases. WPV may be associated with work-related stress.
{"title":"Workplace violence as a predictor of work-related stress among doctors","authors":"Adwitiya Das, M. Datta, S. Banerjee, Soumitra Mondal","doi":"10.4103/amit.amit_27_22","DOIUrl":"https://doi.org/10.4103/amit.amit_27_22","url":null,"abstract":"Introduction: Workplace violence (WPV) toward health-care workers is increasing. The present study aims to estimate the proportion of resident doctors and interns of a tertiary care hospital who experienced WPV, to find out the perpetrators of WPV, and to ascertain any association between WPV and work-related stress. Materials and Methods: This observational, institution-based, cross-sectional study included resident doctors and interns working in six different departments of a tertiary care hospital. Data collection was done using a predesigned, pretested semi-structured self-administered questionnaire adapted and validated from the \"WPV in the health sector survey questionnaire\" from WHO along with \"Perceived occupational stress scale.\" Results: Out of 323 participants, 247 (76.47%) experienced some form of WPV, 138 (42.72%) experienced physical violence and 203 (62.85%) experienced psychological violence. Patient relatives were reported as the only perpetrators of physical violence, while seniors of the study subjects were reported as main perpetrators of psychological violence. One hundred and thirty-four (42%) individuals reported work-related stress. On multivariate analysis, psychological violence was significantly associated with work-related stress. Conclusion: WPV was experienced by a high proportion of study subjects. Psychological violence was more frequently experienced, and senior colleagues were deemed responsible in most cases. WPV may be associated with work-related stress.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"55 1","pages":"93 - 98"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77619703","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}
Introduction: With the rise of the COVID-19 pandemic, digital learning has been implemented in medical colleges across India to continue the ongoing medical education. Anatomy is the basis of medical science and is best learned through offline classes that allow students to experience the texture of structures and handling of specimens. During this pandemic period, cadaveric dissection was not used to study anatomy. The aim of this study was to learn about students' attitudes regarding virtual teaching and learning in anatomy, as well as the problems they may confront. Materials and Methods: A descriptive cross-sectional study was conducted in the department of anatomy among the 50 1st-year MBBS students of All India Institute of Medical Sciences, Rajkot in April 2021. Google Forms were used to obtain informed consent from students. Prevalidated questionnaires were given online to the students and responses were noted and descriptive statistical data was derived from the analysis. Results: About 37 (74%) respondents found traditional classes are better than online teaching. Majority preferred to attend anatomy practicals offline with safety precautions. About 17 (34%) showed interest in prerecorded videos. About 35 (60%) students faced social isolation as an impact of online learning. Technical issues and distractions were the key problems faced while learning anatomy online. Conclusion: Prerecorded videos of the practicals are helpful in teaching anatomy practicals, and can be used in future to ensure an unbroken, continuous, and effective delivery of medical education.
{"title":"Practical anatomy online learning among COVID-19 pandemic era: perceptions of 1st-year MBBS students","authors":"S. Philip, Ranjna Janagal, R. Garg, S. Mehra","doi":"10.4103/amit.amit_52_22","DOIUrl":"https://doi.org/10.4103/amit.amit_52_22","url":null,"abstract":"Introduction: With the rise of the COVID-19 pandemic, digital learning has been implemented in medical colleges across India to continue the ongoing medical education. Anatomy is the basis of medical science and is best learned through offline classes that allow students to experience the texture of structures and handling of specimens. During this pandemic period, cadaveric dissection was not used to study anatomy. The aim of this study was to learn about students' attitudes regarding virtual teaching and learning in anatomy, as well as the problems they may confront. Materials and Methods: A descriptive cross-sectional study was conducted in the department of anatomy among the 50 1st-year MBBS students of All India Institute of Medical Sciences, Rajkot in April 2021. Google Forms were used to obtain informed consent from students. Prevalidated questionnaires were given online to the students and responses were noted and descriptive statistical data was derived from the analysis. Results: About 37 (74%) respondents found traditional classes are better than online teaching. Majority preferred to attend anatomy practicals offline with safety precautions. About 17 (34%) showed interest in prerecorded videos. About 35 (60%) students faced social isolation as an impact of online learning. Technical issues and distractions were the key problems faced while learning anatomy online. Conclusion: Prerecorded videos of the practicals are helpful in teaching anatomy practicals, and can be used in future to ensure an unbroken, continuous, and effective delivery of medical education.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"24 1","pages":"104 - 107"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87198516","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}
Introduction: Brain metastasis (BM) is significantly seen in lung adenocarcinoma and adversely affects survival. We aimed to evaluate the factors affecting the prognosis in patients with BM diagnosed with lung adenocarcinoma. Materials and Methods: Patients with BM between 2012 and 2022 were reviewed retrospectively. Demographic characteristics of the patients, primary tumor characteristics, presence of mutation, BM number, localization, size, development time, and treatment characteristics were evaluated. Inflammatory indices at the time of BM were examined. The overall survival time was calculated. Results: About 92.9% of 113 patients were male, the median age was 62 years (54.5–68.5), and follow-up was 8 months (3–18). BM was detected at the time of diagnosis in 62 (54.9%) of the patients, whereas BM developed later in 51 (45.1%) patients. Systemic treatment was applied to 72.5% of the patients. Survival was lower in patients with BM at diagnosis (4 vs. 14 months, P < 0.001). Primary tumor maximum standardized uptake value level was higher on fluorodeoxyglucose-positron emission tomography-computed tomography at diagnosis in patients with late BM (P = 0.004). The development time of BM was 9 months (4–16), and the median survival was 8 months (6.2–9.8). There was no difference between tumor localization or inflammatory indices and the development of BM and prognosis. The presence of BM at diagnosis and lack of systemic treatment were found to be factors that independently reduced survival (P < 0.001, P = 0.007). Conclusion: The presence of BM at diagnosis significantly reduces survival. It has been observed that systemic treatments applied in addition to local treatments have a positive effect on the prognosis.
{"title":"Prognostic factors in lung adenocarcinoma with brain metastasis","authors":"E. Karaman, Sema Yilmaz Rakici","doi":"10.4103/amit.amit_61_22","DOIUrl":"https://doi.org/10.4103/amit.amit_61_22","url":null,"abstract":"Introduction: Brain metastasis (BM) is significantly seen in lung adenocarcinoma and adversely affects survival. We aimed to evaluate the factors affecting the prognosis in patients with BM diagnosed with lung adenocarcinoma. Materials and Methods: Patients with BM between 2012 and 2022 were reviewed retrospectively. Demographic characteristics of the patients, primary tumor characteristics, presence of mutation, BM number, localization, size, development time, and treatment characteristics were evaluated. Inflammatory indices at the time of BM were examined. The overall survival time was calculated. Results: About 92.9% of 113 patients were male, the median age was 62 years (54.5–68.5), and follow-up was 8 months (3–18). BM was detected at the time of diagnosis in 62 (54.9%) of the patients, whereas BM developed later in 51 (45.1%) patients. Systemic treatment was applied to 72.5% of the patients. Survival was lower in patients with BM at diagnosis (4 vs. 14 months, P < 0.001). Primary tumor maximum standardized uptake value level was higher on fluorodeoxyglucose-positron emission tomography-computed tomography at diagnosis in patients with late BM (P = 0.004). The development time of BM was 9 months (4–16), and the median survival was 8 months (6.2–9.8). There was no difference between tumor localization or inflammatory indices and the development of BM and prognosis. The presence of BM at diagnosis and lack of systemic treatment were found to be factors that independently reduced survival (P < 0.001, P = 0.007). Conclusion: The presence of BM at diagnosis significantly reduces survival. It has been observed that systemic treatments applied in addition to local treatments have a positive effect on the prognosis.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"1 1","pages":"118 - 123"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83036605","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}
Archita Bhattacharya, M. Das, Sangeeta Ghosh, A. Samanta
Introduction: Recent COVID-19 pandemic is an unprecedented public health problem worldwide. Knowledge about the disease and adoption of COVID Appropriate Behavior (CAB) are of utmost importance in combating the pandemic. The study was conducted to assess and compare the knowledge, attitude, and practice and to determine different misconceptions and wrong practices related to the disease among urban and rural populations. Materials and Methods: A community-based analytical study with cross-sectional design was conducted from January 2021 to March 2021 among 144 adult residents from urban and rural West Bengal. Multistage sampling was adopted and a predesigned, pretested, semistructured schedule was used for interviewing study subjects. Results: Urban people were significantly more knowledgeable and more appropriate in attitude and practice than rural people (P < 0.05). The mean knowledge and attitude scores of urban population were significantly higher than the rural population across age groups, gender, occupation, and education (P < 0.05), whereas mean practice score was significantly higher across gender and occupation in the urban population compared to the rural population (P < 0.05). Many cultural and indigenous practices such as drinking warm water, using mouth wash, using home remedies were more common in urban areas and consumption of homeopathy medicines, lighting candles, making sound with utensils, blowing conch shells, and worshipping corona were observed more in rural areas. Conclusions: Wide gap exists in knowledge, attitude, and practice between urban and rural population and there were many wrong perceptions and practices surrounding COVID-19 among both urban and rural population. Appropriate policy for improving knowledge, attitude, and CAB is the need of the hour.
{"title":"Perception and practices of COVID appropriate behavior: A cross-sectional study among adult populations in rural and urban West Bengal","authors":"Archita Bhattacharya, M. Das, Sangeeta Ghosh, A. Samanta","doi":"10.4103/amit.amit_23_22","DOIUrl":"https://doi.org/10.4103/amit.amit_23_22","url":null,"abstract":"Introduction: Recent COVID-19 pandemic is an unprecedented public health problem worldwide. Knowledge about the disease and adoption of COVID Appropriate Behavior (CAB) are of utmost importance in combating the pandemic. The study was conducted to assess and compare the knowledge, attitude, and practice and to determine different misconceptions and wrong practices related to the disease among urban and rural populations. Materials and Methods: A community-based analytical study with cross-sectional design was conducted from January 2021 to March 2021 among 144 adult residents from urban and rural West Bengal. Multistage sampling was adopted and a predesigned, pretested, semistructured schedule was used for interviewing study subjects. Results: Urban people were significantly more knowledgeable and more appropriate in attitude and practice than rural people (P < 0.05). The mean knowledge and attitude scores of urban population were significantly higher than the rural population across age groups, gender, occupation, and education (P < 0.05), whereas mean practice score was significantly higher across gender and occupation in the urban population compared to the rural population (P < 0.05). Many cultural and indigenous practices such as drinking warm water, using mouth wash, using home remedies were more common in urban areas and consumption of homeopathy medicines, lighting candles, making sound with utensils, blowing conch shells, and worshipping corona were observed more in rural areas. Conclusions: Wide gap exists in knowledge, attitude, and practice between urban and rural population and there were many wrong perceptions and practices surrounding COVID-19 among both urban and rural population. Appropriate policy for improving knowledge, attitude, and CAB is the need of the hour.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"1 1","pages":"85 - 92"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88591964","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}
Soumitra Mondal, S. Bhattacharya, P. Jana, K. Mitra
introduction: A health-care beneficiary should comprehend different aspects of medical and surgical interventions before giving consent to perform those. There is no defined way to find out adequate patient comprehension as part of the decision-making procedure to give consent. This study was conducted to find out the disparity of comprehensiveness between emergency and elective surgical operative procedures both in terms of knowledge dissemination and knowledge comprehension. Materials and Methods: A cross-sectional comparative study was conducted at the General Surgery Department of Medical College, Kolkata, during September and October 2021. An interviewer-administered questionnaire was used on patients undergoing emergency and elective surgical procedures. The comprehension level of informed consent (IC) form was scored as 1, 2, and 3 and compared between two groups using an unpaired t-test and Mann–Whitney U-test. Result: Data collection was done from 39 patients for emergency operative procedures and 52 for elective surgical procedures. A composite comprehension score was calculated after adjusting for questions not asked while taking IC. The mean comprehension score for emergency procedures was 18.86 and for planned surgery, it was 20.14. Unpaired t-test showed significantly high mean comprehension for planned procedures than the emergency procedures (P = 0.007). Comprehension is significantly poorer in emergency conditions even after controlling for age and literacy denoting difficulty in decision-making in emergency scenarios. Conclusion: It is suggested that the procedure of consent taking should be more structured and interactive so that even in stressful conditions participant understand better about the procedures and take their own decision instead of relying blindly on doctors.
{"title":"A comparative study on comprehension of informed consent before emergency and elective surgical operative procedures","authors":"Soumitra Mondal, S. Bhattacharya, P. Jana, K. Mitra","doi":"10.4103/amit.amit_90_22","DOIUrl":"https://doi.org/10.4103/amit.amit_90_22","url":null,"abstract":"introduction: A health-care beneficiary should comprehend different aspects of medical and surgical interventions before giving consent to perform those. There is no defined way to find out adequate patient comprehension as part of the decision-making procedure to give consent. This study was conducted to find out the disparity of comprehensiveness between emergency and elective surgical operative procedures both in terms of knowledge dissemination and knowledge comprehension. Materials and Methods: A cross-sectional comparative study was conducted at the General Surgery Department of Medical College, Kolkata, during September and October 2021. An interviewer-administered questionnaire was used on patients undergoing emergency and elective surgical procedures. The comprehension level of informed consent (IC) form was scored as 1, 2, and 3 and compared between two groups using an unpaired t-test and Mann–Whitney U-test. Result: Data collection was done from 39 patients for emergency operative procedures and 52 for elective surgical procedures. A composite comprehension score was calculated after adjusting for questions not asked while taking IC. The mean comprehension score for emergency procedures was 18.86 and for planned surgery, it was 20.14. Unpaired t-test showed significantly high mean comprehension for planned procedures than the emergency procedures (P = 0.007). Comprehension is significantly poorer in emergency conditions even after controlling for age and literacy denoting difficulty in decision-making in emergency scenarios. Conclusion: It is suggested that the procedure of consent taking should be more structured and interactive so that even in stressful conditions participant understand better about the procedures and take their own decision instead of relying blindly on doctors.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"74 1","pages":"153 - 158"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85204132","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：