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What's new in academic international medicine? Improving the state of representation in the neurosurgical workforce 国际医学学术有什么新进展?提高神经外科工作人员的代表性
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/ijam.ijam_106_22
C. Schill, Frank Cedeño, D. Rabin
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引用次数: 1
Emergency medicine resident involvement in emergency medical services 急诊医学住院医师参与急诊医疗服务
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/ijam.ijam_116_21
Natalie Akers, Bryan Wilson, A. Ray
Introduction: Emergency medical services (EMS) are a critical component to Emergency Medicine (EM) residency training. In the United States, the Accreditation Council for Graduate Medical Education (ACGME) has established minimum training requirements for EM residency programs. Since the last study exploring resident EMS involvement was performed, there have been over 100 new EM resident programs started. Given the rapid increase in new EM programs, we sought to determine EMS experiences provided to current EM residents. Materials and Methods: A 22-question anonymous online survey was distributed through E-mail to program directors of approved EM residencies in October 2020. A follow-up reminder was sent 3 weeks later. Results: In total, 51 of 257 programs responded (20% response rate). Forty-five percent of EM residents experience between 10 and 25 EMS calls during their residency, 31% experience 26–50, and 20% experience >50 calls. The majority of programs (53%) have a separate EMS rotation where residents function as observers, 24% of residents function as providers, and 25% also have residents respond in a dedicated physician response vehicle. Aeromedical exposure is limited (47% have none and 43% average only 1–9 flights). Two-thirds of programs (67%) have residents provide online medical command during their ED shifts and 61% require residents to provide didactics to EMS clinicians. Despite ACGME requirements, only two-thirds of programs (69%) provide training about disaster/mass casualty incident (MCI) management and 67% have them participate in a disaster/MCI drill. About one-third of programs (31%) have decreased EMS experiences due to limited time in the residency curriculum, and 20% of programs have limited EMS experiences due to the COVID pandemic. Conclusions: The majority of responding EM residency programs meet ACGME EMS-related requirements. There is an opportunity for improvement around disaster education based on these data. Limited time in the curriculum and the COVID pandemic were cited as reasons that programs have limited their EMS experiences. The following core competencies are addressed in this article: Practice-Based Learning and Improvement, Medical Knowledge.
简介:急诊医疗服务(EMS)是急诊医学(EM)住院医师培训的重要组成部分。在美国,研究生医学教育认证委员会(ACGME)已经建立了EM住院医师计划的最低培训要求。自从上一项关于住院医生参与急救的研究开始以来,已经有超过100个新的住院医生项目启动。鉴于新兴医疗项目的快速增长,我们试图确定为当前的新兴医疗居民提供的医疗服务经验。材料与方法:一份包含22个问题的匿名在线调查于2020年10月通过电子邮件发送给已批准的新兴市场住院医师项目主管。3周后发送了后续提醒。结果:257个项目中有51个项目有响应(20%的回复率)。45%的急诊医生在住院期间会接到10到25个急诊电话,31%的人会接到26到50个急诊电话,20%的人会接到100到50个急诊电话。大多数项目(53%)有单独的EMS轮转,其中住院医生作为观察员,24%的住院医生作为提供者,25%的住院医生也在专门的医生响应车辆中响应。航空医疗接触是有限的(47%没有,43%平均只有1-9次飞行)。三分之二(67%)的项目要求住院医师在急诊科轮班期间提供在线医疗指令,61%的项目要求住院医师向EMS临床医生提供指导。尽管有ACGME的要求,但只有三分之二(69%)的项目提供灾难/大规模伤亡事件(MCI)管理培训,67%的项目让他们参加灾难/MCI演习。大约三分之一(31%)的项目由于住院医师课程时间有限而减少了EMS经验,20%的项目由于COVID大流行而减少了EMS经验。结论:大多数响应的急诊住院医师项目符合ACGME的急诊相关要求。基于这些数据,我们有机会改进灾害教育。课程时间有限和新冠疫情被认为是项目限制EMS经验的原因。本文讨论了以下核心能力:基于实践的学习和改进,医学知识。
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引用次数: 0
Nutritional assessment of birth outcomes of gestational diabetic mothers in Gaza Strip, Palestine: A retrospective case-control study 巴勒斯坦加沙地带妊娠期糖尿病母亲出生结局的营养评估:一项回顾性病例对照研究
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/ijam.ijam_153_21
I. Naser, M. Shaat, M. Taleb, A. Najim
Introduction: Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy. Numerous studies have dealt with risk factors of GDM, while others studied the health complications associated with GDM. This study aimed to investigate the association between GDM and nutritional birth outcomes in Gaza Strip, Palestine. Materials and Methods: The study utilized the case−control design where 44 GDM mothers and 44 non-GDM mothers were recruited. The study was conducted at the obstetric departments at Al-Shifa Maternity Hospital in Gaza and Mubarak Maternity Hospital in Khan Yunis. Data collection included anthropometric measurement and hematological indicators and other pertinent information through a structured questionnaire. Results: The result reported that the mean age of GDM pregnant women and non-GDM was 31 ± 11.5 and 23 ± 6.75 years, respectively. 13.6% had anemia, 20.5% had previous delivery of macrosomic baby, 15.9% had hypertension, and 11.4% were obese. In addition, 63.6% of GDM mothers had a family history of diabetes and 18.2% had a family history of GDM. 43.2% of GDM mothers delivered by cesarean section (CS) and 13.6% of GDM mothers had a premature delivery. Assessment of dietary intake indicated that 40.9% of GDM mothers have breakfast regularly. The neonatal median birth weight was 3.22 kg for babies of GDM mothers and 3.30 kg for babies of non-GDM mothers, and the median length was 52 cm versus 50 cm; 6.8% of neonates of GDM mothers had low Apgar score. Neonates of GDM mothers expressed significantly lower blood sugar (P = 0.039), lower albumin (P = 0.037), and higher soluble surface receptors – surface transferrin receptor (P = 0.017), but there were no statistically significant differences in the other hematological parameters. Conclusion: The study reflected a significant association between GDM and lower blood glucose, serum albumin, and iron status. Furthermore, the study reflected a significant association between GDM and CS delivery and neonatal hypoglycemia. The study emphasized the need to integrate clinical nutrition services in maternity departments and antenatal clinics and encourage physical activities during pregnancy. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge.
妊娠期糖尿病(GDM)是妊娠期最常见的代谢紊乱。许多研究涉及GDM的危险因素,而其他研究则研究与GDM相关的健康并发症。本研究旨在调查巴勒斯坦加沙地带GDM与营养出生结局之间的关系。材料和方法:本研究采用病例对照设计,招募了44名GDM母亲和44名非GDM母亲。这项研究是在加沙的Al-Shifa妇产医院和汗尤尼斯的穆巴拉克妇产医院的产科进行的。数据收集包括人体测量和血液学指标及其他相关信息,通过结构化问卷。结果:GDM孕妇和非GDM孕妇的平均年龄分别为31±11.5岁和23±6.75岁。13.6%有贫血,20.5%有过大婴儿,15.9%有高血压,11.4%有肥胖。此外,63.6%的GDM母亲有糖尿病家族史,18.2%有GDM家族史。43.2%的GDM母亲通过剖宫产(CS)分娩,13.6%的GDM母亲早产。饮食摄入评估表明,40.9%的GDM母亲经常吃早餐。GDM母亲的新生儿出生体重中位数为3.22 kg,非GDM母亲的新生儿出生体重中位数为3.30 kg,平均长度为52 cm对50 cm;6.8%的GDM母亲的新生儿Apgar评分低。GDM母亲的新生儿血糖显著降低(P = 0.039),白蛋白显著降低(P = 0.037),可溶性表面受体-表面转铁蛋白受体显著升高(P = 0.017),但其他血液学指标差异无统计学意义。结论:该研究反映了GDM与低血糖、血清白蛋白和铁状态之间的显著关联。此外,该研究反映了GDM和CS分娩与新生儿低血糖之间的显著关联。该研究强调需要在产科和产前诊所整合临床营养服务,并鼓励怀孕期间的体育活动。本文讨论了以下核心能力:患者护理和程序技能、医学知识。
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引用次数: 0
The Seventh Annual Academic International Medicine Virtual Congress and Scientific Forum, June 9–12, 2022: Building a Stronger Future 第七届国际学术医学虚拟大会和科学论坛,2022年6月9日至12日:建设更强大的未来
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/ijam.ijam_104_22
M. Firstenberg, A. De Wulf, M. Narayan, Taryn Clark, Andrew C. Miller, S. Stawicki
As the COVID-19 pandemic continued to fade, first glimpses of “post-pandemic normal” began to emerge in the late 2021 and early 2022. This new hope came with a positive new momentum – an opportunity to transform and reinvent. Yet given a high degree of uncertainty extending well into 2022, the American College of Academic International Medicine made a strategic decision in the late 2021 to move forward with Virtual 7th Annual Congress and Scientific Forum (AIM 2022). The theme of this year's meeting was “Building a Stronger Future” and reflected the early post-pandemic optimism. Primary organization of the meeting was facilitated by the Sarasota Memorial Health Care System, Sarasota, Florida, with substantial contributions provided by Northwell Health, Long Island, New York. The Scientific Forum once again took place virtually, enabling participants from around the globe to present their research. A summary of these efforts and outcomes is provided in this article. The following core competencies are addressed in this article: Interpersonal and communication skills, Professionalism, Practice-based learning and improvement, Systems based practice.
随着新冠肺炎疫情的持续消退,2021年末和2022年初开始出现“疫情后正常”的初步迹象。这种新的希望伴随着一种积极的新势头——一个转变和重塑的机会。然而,考虑到一直持续到2022年的高度不确定性,美国国际医学院在2021年底做出了一项战略决定,即推进虚拟第七届年度大会和科学论坛(AIM 2022)。今年会议的主题是“建设更强大的未来”,反映了疫情后早期的乐观情绪。会议的主要组织由佛罗里达州萨拉索塔的萨拉索塔纪念医疗保健系统提供了便利,纽约长岛的Northwell Health提供了大量捐款。科学论坛再次以虚拟方式举行,使来自世界各地的与会者能够介绍他们的研究成果。本文对这些努力和成果进行了总结。本文讨论了以下核心能力:人际交往和沟通技能、专业精神、基于实践的学习和改进、基于系统的实践。
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引用次数: 0
A 5-year analysis of admissions, seasonal variation, and patient outcomes in rural Nigeria: A retrospective observational study 尼日利亚农村地区入院、季节变化和患者预后的5年分析:一项回顾性观察性研究
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/ijam.ijam_60_21
A. Ibrahim, T. Agbesanwa, S. Aremu, S. Agboola, O. Shabi, B. Afolabi
Introduction: In low- and middle-income countries like Nigeria, there is an observed paucity of data on the admission pattern and patient outcomes in health facilities. Few related studies were conducted in the urban centers, but none from the rural areas where the majority of the populace resides. This study is to ascertain the demographic profile, seasonal variations, yearly distribution, admission pattern, and treatment outcomes at the accident and emergency department (AED). Materials and Methods: A retrospective survey was used to review the data of patients admitted to the AED of the institution between January 2015 and December 2019. The data obtained were analyzed using SPSS Version 20.0. The results were presented in descriptive and tabular formats. Results: Five thousand nine hundred and forty-four patients were studied with a mean age of 49.8 ± 19 years. There were 53.9% males and 46.1% females. Many (60.1%) were admitted from April to October. There were 58.9% medical and 41.1% surgical cases. Among the medical cases were 18.6% noncommunicable and 18.5% communicable diseases. Out of 5944 patients, 9435 disease patterns were diagnosed with infectious diseases 15.5%, and orthopedic 14.4% being the most frequently diagnosed medical and surgical cases, respectively. The treatment outcome revealed that the mortality rate was 3.7%. Conclusions: The number of admissions increased over 5 years. Although most patients were treated and discharged successfully, the number discharged against medical advice was high. Therefore, appropriate hospital and community interventions should be implemented to improve admission outcomes. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, and Systems-based practice.
引言:在尼日利亚等中低收入国家,观察到卫生机构的入院模式和患者结果数据匮乏。很少在城市中心进行相关研究,但没有在大多数人口居住的农村地区进行相关研究。本研究旨在确定人口统计学特征、季节变化、年度分布、入院模式和急诊科(AED)的治疗结果。材料和方法:采用回顾性调查,回顾2015年1月至2019年12月期间入住该机构AED的患者的数据。使用SPSS 20.0版对获得的数据进行分析。结果以描述性和表格形式呈现。结果:研究了594名患者,平均年龄为49.8±19岁。男性53.9%,女性46.1%。许多人(60.1%)在4月至10月入院。其中58.9%为内科病例,41.1%为外科病例。在医疗病例中,非传染性疾病占18.6%,传染性疾病占18.5%。在5944名患者中,9435种疾病类型被诊断为感染性疾病,分别占15.5%和14.4%,是最常见的医疗和外科诊断病例。治疗结果显示,死亡率为3.7%。结论:入院人数在5年内有所增加。尽管大多数患者都得到了成功的治疗和出院,但违背医嘱出院的人数却很高。因此,应实施适当的医院和社区干预措施,以改善入院结果。本文讨论了以下核心能力:患者护理和程序技能、医学知识和基于系统的实践。
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引用次数: 0
Conference proceedings: Fourth annual women in medicine summit: An evolution of empowerment 2022 会议记录:第四届年度医学女性峰会:2022年赋权的演变
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/2455-5568.365559
Marah Kays, Michelle Fernando, Mysa Abdelrahman, Deborah D. Rupert, Parul Barry, Shikha Jain
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引用次数: 0
Esophageal melanosis due to mishri usage: A case with uncommon finding and rare etiology 米什里使用引起的食管黑变病:一例罕见且病因罕见的病例
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/ijam.ijam_67_22
M. Girish, A. Dahale, D. Banerjee, Prasad Bhate, A. Karad
Esophageal melanosis (EM) is a rare disease of the upper digestive system. We present a case series of two patients with EM who presented with dysphagia and had the habit of mishri consumption. Endoscopy showed black-pigmented spots involving the upper and mid esophagus. EM due to mishri consumption was a rare presentation as there were no cases reported till date. The following core competencies are addressed in this article: Patient care, Practice-based learning and improvement, Medical knowledge.
食道黑变病是一种罕见的上消化系统疾病。我们介绍了一个由两名EM患者组成的病例系列,他们出现吞咽困难并有食用米什里的习惯。内窥镜检查显示食道上部和中部有黑色色素斑点。由于食用米什里引起的EM是一种罕见的表现,因为到目前为止还没有病例报告。本文涉及以下核心能力:患者护理、基于实践的学习和改进、医学知识。
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引用次数: 0
Compliance rate of anti-rabies vaccination in patients presenting with an animal bite 动物咬伤患者抗狂犬病疫苗接种依从率
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-10-01 DOI: 10.4103/ijam.ijam_54_22
Rathijit Pal, Vaishnavi Vegiraju, D. Hazra, A. Nekkanti, K. Abhilash
Introduction: To prevent rabies in animal bite victims, complete postexposure prophylaxis (PEP) with an anti-rabies vaccination (ARV) is essential. This study was done to determine the compliance rate of ARV in patients with animal bites who presented to the emergency department (ED) during the COVID-19 pandemic. Materials and Methods: This was a prospective observational study done on patients presenting to the ED with a history of animal bites over 1 year (May 2020–June 2021). Categorical variables were presented as percentages, and quantitative variables were summarized using mean and standard deviation (SD). Results: A total of 122 animal bite (World Health Organization [WHO] Category II and III) victims presented to the ED during the study. The mean age of the cohort was 38.12 (SD: 16.4) years with a male (n = 67: 54.9%) preponderance. Based on the physiological stability, a majority were triaged as priority III (n = 119; 97.5%). Most patients presented with dog bites (n = 88; 72.1%), followed by cat (n = 14; 11.5%) and rat bites (n = 13; 10.7%). Two-thirds were unprovoked (n = 82; 67.2%) and were caused by stray animals (n = 62; 50.8%). More than half (n = 65; 53.3%) of the bites were WHO Category III bites. All Category II and III patients had received the first dose of ARV at our center and category III patients received immunoglobulin local injection as well. Noncompliance to ARV was seen in almost a quarter (n = 32; 26.2%) of patients of which forgotten dates (n = 11; 34.4%) were the most common cause. There was no significant statistical variable to determine the cause of noncompliance. Conclusion: Unprovoked bites by stray dogs were the cause of a majority of the animal bites. Compliance with PEP remains low at two-thirds of the total. The most common cause of noncompliance to ARV was due to forgotten dates. The following core competencies are addressed in this article: Medical knowledge, Systems-based practice, Practice-based learning and improvement.
引言:为了预防动物咬伤患者的狂犬病,必须进行完整的暴露后预防(PEP)和抗狂犬病疫苗接种(ARV)。本研究旨在确定新冠肺炎大流行期间急诊科(ED)动物咬伤患者的ARV依从率。材料和方法:这是一项前瞻性观察性研究,针对有1年以上动物咬伤史的急诊患者(2020年5月至2021年6月)。分类变量以百分比表示,定量变量使用平均值和标准差(SD)进行总结。结果:在研究期间,共有122名动物咬伤(世界卫生组织世界卫生组织]第二类和第三类)受害者向ED报告。该队列的平均年龄为38.12岁(标准差:16.4),男性(n=67:54.9%)占优势。根据生理稳定性,大多数患者被分为III级(n=119;97.5%)。大多数患者被狗咬伤(n=88;72.1%),其次是猫咬伤(n=14;11.5%)和老鼠咬伤(n=13;10.7%)。三分之二是无端咬伤(n=82;67.2%),由流浪动物引起(n=62;50.8%)。超过一半(n=65;53.3%)的咬伤是世界卫生组织III级咬伤。所有II类和III类患者都在我们的中心接受了第一剂抗逆转录病毒药物,III类患者也接受了免疫球蛋白局部注射。近四分之一(n=32;26.2%)的患者不遵守抗逆转录病毒药物,其中忘记日期(n=11;34.4%)是最常见的原因。没有显著的统计变量来确定不合规的原因。结论:流浪狗未经孵化的咬伤是造成大多数动物咬伤的原因。对政治公众人物的遵守率仍然很低,仅占总数的三分之二。不遵守ARV的最常见原因是忘记日期。本文讨论了以下核心能力:医学知识、基于系统的实践、基于实践的学习和改进。
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引用次数: 0
Association between iron-deficiency anemia and antenatal depression in a semi-urban population of south India: A cross-sectional study 缺铁性贫血与印度南部半城市人口产前抑郁之间的关系:一项横断面研究
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-07-01 DOI: 10.4103/ijam.ijam_133_21
R. Basutkar, P. Sudarsan, C. Vinod, Resia Varghese, Divya Perumal, P. Sivasankaran
Introduction: Iron-deficiency anemia (IDA) during pregnancy affects the glial cells of the brain of mother, which results in altered neuronal myelination with dysregulation. Although several factors could lead to antenatal depression, IDA is an emerging etiology. The primary objective of this study is to determine the relationship between IDA and antenatal depression among pregnant women. Materials and Methods: This cross-sectional study was conducted at Government Head Quarters and Hospital, in Udhagamandalam. A total of 210 pregnant women in the second trimester were enrolled and categorized into iron-deficient anemia and noniron-deficient anemia groups based on their hematological results. The risk of depression was assessed using the validated Edinburgh Depression Scale (EDS). A Chi-square test for categorical variables and an independent t-test for continuous variables were used. A Pearson's correlation analysis was performed to check the association of EDS scores with participants' demographic characteristics and hematological parameters. Regression analysis was conducted to predict the outcome variable. Results: The distribution of depression was significantly varied between the groups. EDS score was significantly higher in the IDA group in comparison with the non-IDA group (12.78 ± 3.40 vs. 8.82 ± 3.12; P = 0.005; 95% confidence interval 2.94–4.87). The odds of developing antenatal depression are 12 times higher in the iron-deficient group, P < 0.001. Conclusions: Our findings suggest that IDA acts as an independent factor in influencing antenatal depression. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement.
妊娠期缺铁性贫血(IDA)会影响母体大脑的神经胶质细胞,导致神经元髓鞘形成改变并失调。虽然一些因素可能导致产前抑郁,IDA是一个新兴的病因。本研究的主要目的是确定IDA与孕妇产前抑郁之间的关系。材料和方法:本横断面研究在Udhagamandalam的政府总部和医院进行。共有210名妊娠中期的孕妇被纳入研究,并根据血液学结果分为缺铁性贫血和非缺铁性贫血两组。采用经验证的爱丁堡抑郁量表(EDS)评估抑郁风险。分类变量采用卡方检验,连续变量采用独立t检验。采用Pearson相关分析检验EDS评分与受试者人口学特征和血液学参数的相关性。采用回归分析预测结局变量。结果:两组患者抑郁程度分布差异有统计学意义。IDA组EDS评分明显高于非IDA组(12.78±3.40∶8.82±3.12;P = 0.005;95%置信区间2.94-4.87)。缺铁组发生产前抑郁的几率是缺铁组的12倍,P < 0.001。结论:我们的研究结果表明,IDA是影响产前抑郁的一个独立因素。本文讨论了以下核心能力:医学知识、患者护理、基于实践的学习和改进。
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引用次数: 0
Flipped journal club: A way forward in postgraduate medical education 翻转期刊俱乐部:医学研究生教育的前进之路
IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-07-01 DOI: 10.4103/ijam.ijam_33_22
M. Taywade, Debkumar Pal, Ranjana Kalra, Kumbha Gopi, Shampa Maji
After its origin during the 18th century, the journal club has come a long way as an effective method of pedagogy in postgraduate medical education. As the traditional format of the journal club is becoming less attractive for residents, the newer concept of blended learning and flipped classrooms is now being incorporated slowly into the traditional format of the journal club. This newer format of journal club is called flipped journal club, where all materials regarding the article are shared among residents and faculty well before the day of presentation. On the presentation day, there is a small group discussion regarding the summary, critical appraisal, and its implication on the concerned subject. The following core competencies are addressed in this article: Practice-based learning and improvement, Systems-based practice, Medical knowledge, Professionalism.
期刊俱乐部起源于18世纪,作为医学研究生教育的一种有效的教育方法,它已经取得了长足的进步。随着期刊俱乐部的传统形式对居民的吸引力越来越小,混合学习和翻转教室的新概念现在正慢慢融入期刊俱乐部的常规形式。这种较新形式的期刊俱乐部被称为翻转期刊俱乐部,在这里,与文章有关的所有材料都会在发表当天之前在居民和教职员工之间共享。演讲当天,有一个小组讨论,内容涉及总结、批判性评价及其对相关主题的影响。本文讨论了以下核心能力:基于实践的学习和改进、基于系统的实践、医学知识、专业精神。
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引用次数: 1
期刊
International Journal of Academic Medicine
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