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SARS-CoV-2 variant: Its clinical importance and molecular epidemiology SARS-CoV-2变异的临床意义及分子流行病学研究
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_76_20
V. Wiwanitkit
Coronavirus disease 2019 (COVID-19) is a newly emerging disease. COVID-19 pandemic becomes a global problem in 2020. The disease causes more than 22 infected persons worldwide. Since this respiratory infection is a new coronavirus infection, the knowledge of its clinical epidemiology is very important for proper management. The diagnosis of the infection is usually based on molecular diagnosis. The molecular study of the pathogenic virus, SARS-CoV-2, might detect a mutated virus. The COVID-19 with mutated virus is an interesting emerging problem in medicine. There are some new reported on SARS-CoV-2 variants that are associated with altered clinical feature. In this short review article, the author summarizes and discusses the data on SARS-CoV-2 variant. The clinical importance and molecular epidemiology of SARS-CoV-2 variant are focused on the present article.
2019冠状病毒病(新冠肺炎)是一种新出现的疾病。新冠肺炎大流行在2020年成为一个全球性问题。这种疾病在全世界造成超过22名感染者。由于这种呼吸道感染是一种新型冠状病毒感染,了解其临床流行病学对正确管理非常重要。感染的诊断通常基于分子诊断。对致病病毒严重急性呼吸系统综合征冠状病毒2型的分子研究可能会检测到一种变异病毒。带有变异病毒的新冠肺炎是医学中一个有趣的新问题。有一些关于严重急性呼吸系统综合征冠状病毒2型变异株的新报道与临床特征的改变有关。在这篇简短的综述文章中,作者总结并讨论了严重急性呼吸系统综合征冠状病毒2型变异株的数据。本文重点介绍了严重急性呼吸系统综合征冠状病毒2型变异株的临床意义和分子流行病学。
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引用次数: 1
COVID-19, detection in a country and treatment in another country – Issue on international referral COVID-19,在一个国家发现,在另一个国家治疗——关于国际转诊的问题
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_47_20
V. Wiwanitkit
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引用次数: 0
A study of factors affecting visual outcome in small incision cataract surgery 影响小切口白内障手术视力的因素研究
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_77_20
Renu Magdum, I. Mushtaq, Aishwarya Koul
Introduction: In spite of the changing patterns of blindness seen globally, cataract remains the most common cause of blindness worldwide. Modern cataract surgery aims to achieve a better unaided visual acuity (VA) with rapid postsurgical recovery and minimal complications. Small incision cataract surgery (SICS) is the most common cataract surgery done all over the world due to its nondependence on expensive machines and easier learning curve. VA following surgery is one of the key indicators for evaluating the quality of surgery. Materials and Methods: This descriptive observational study was conducted in the ophthalmology department of a tertiary care hospital. It included 50 eyes of patients with uncomplicated senile cataract who underwent SICS. Patients were first evaluated for cataract using visual assessment, slit-lamp examination, ophthalmoscopy, and B-scan in case of mature cataracts. Results: Age of patients varied from 39 to 72 years. The hardness of the nucleus varied from Grade 1 to Grade 4 by lens opacities classification system III classification. The types of cataract operated were cortical cataract with posterior subcapsular cataract (n = 36) and nuclear cataract (n = 16). Thirty-eight eyes out of 50 eyes (68%) had unaided VA of 6/18–6/60, whereas only 24% of eyes had vision better than 6/18 on POD 1. Unaided visual outcome on POD 7 showed 60% cases with VA better than 6/18. In two cases, vision remained below 6/60. Intraocular lens power was determined using the SRK II formula. In majority of cases (48%), the incision size was between 6.5 and 7 mm. The contour of the external incision was straight in 72% cases and frown shape in 14% cases. Most eyes showed improvement of vision between 1st and 7th postoperative day. However, in one eye, vision remained below 6/60. Conclusions: Sight restoring cataract surgery is undoubtedly one of society's most cost-effective medical commonly done surgeries not only in India but also all over the world. All grades of nuclear sclerosis can be dealt with by this technique. A surgeon can further improve his/her postoperative results by giving due attention to the site, size, and contour of his/her incisions and taking care to protect the corneal endothelium while doing intraocular maneuvers and nucleus removal.
引言:尽管全球失明模式不断变化,白内障仍然是全球最常见的失明原因。现代白内障手术旨在获得更好的独立视力(VA),术后恢复迅速,并发症最小。小切口白内障手术(SICS)是世界上最常见的白内障手术,因为它不依赖昂贵的机器和更容易的学习曲线。术后VA是评价手术质量的关键指标之一。材料和方法:这项描述性观察性研究在一家三级护理医院的眼科进行。包括50眼接受SICS的无并发症老年性白内障患者。患者首先通过视力评估、裂隙灯检查、检眼镜和成熟白内障的B扫描来评估白内障。结果:患者年龄39~72岁。根据晶状体混浊度分类系统III的分类,细胞核的硬度从1级到4级不等。白内障手术类型为皮质白内障、后囊下白内障(n=36)和核性白内障(n=16)。50只眼睛中有38只眼睛(68%)的独立视力为6/18–6/60,而只有24%的眼睛在POD 1上的视力优于6/18。POD 7的独立视觉结果显示60%的VA优于6/18。在两个病例中,视力保持在6/60以下。使用SRK II公式测定人工晶状体度数。在大多数病例(48%)中,切口大小在6.5至7mm之间。72%的病例外切口轮廓是直的,14%的病例为皱眉形状。大多数眼睛在术后第1天至第7天显示视力改善。然而,其中一只眼睛的视力仍低于6/60。结论:复明白内障手术无疑是社会上最具成本效益的医疗手术之一,不仅在印度,而且在世界各地都是如此。所有级别的核硬化症都可以用这种技术治疗。外科医生可以通过适当注意切口的位置、大小和轮廓,并在进行人工操作和摘除核的同时注意保护角膜内皮,进一步改善其术后效果。
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引用次数: 0
Development and validation of a new tool (TerHosQual) for assessing service quality in a tertiary care hospital 开发和验证用于评估三级保健医院服务质量的新工具(TerHosQual)
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_44_20
B. Chandrashekar, Shalini Natarajappa, M. Ravi, P. Nagesh
Background: Evaluating service quality (SQ) is an important consideration in the era of ever-increasing inflow of patients through medical tourism. This not only influences the satisfaction of customers but also their purchase intentions. Objective: The objective was to develop and validate a new tool (TerHosQual) for assessing SQ in a tertiary care hospital in Mysore, India. Materials and Methods: Initial tool consisting of 72 items was drafted by synthesizing literature review and inputs from subject experts. The items were segregated into 13 dimensions in consultation with three internal experts. Content validation was done by 12 subject experts. Based on their inputs, 21 items were deleted from the initial tool (8 items for lack of relevance, 6 items for lack of appropriateness, 3 items for lack of clarity of words, and 4 items for redundancy). Response process validity of the final tool consisting of 51 items under 13 dimensions was done using cognitive interview (retrospective verbal probing method). Test–retest reliability assessment was done on ten prospective participants to assess the reliability of the tool before pilot testing the tool on 30 participants. Results: It was found that the Cronbach's alpha if item deleted did not show significant improvement for any of 51 items in the tool as well as for 13 dimensions. The Cronbach's alpha coefficient for 51 items in the tool was 0.95 and for 13 dimensions, it was 0.87, indicating a high degree of reliability of the items in the tool under these dimensions. Conclusion: The pilot study demonstrated the feasibility of using this new tool in a tertiary care hospital while indicating the reliability of the tool. However, the tool needs to be further evaluated using a larger sample size and factor analysis to validate these results of the pilot study.
背景:在医疗旅游患者不断涌入的时代,评估服务质量是一个重要的考虑因素。这不仅影响顾客的满意度,也影响他们的购买意愿。目的:目的是开发和验证一种新的工具(TerHosQual),用于评估印度迈索尔一家三级护理医院的SQ。材料和方法:通过综合文献综述和学科专家的意见,起草了由72个项目组成的初始工具。与三名内部专家协商后,将这些项目分为13个方面。内容验证由12位主题专家完成。根据他们的输入,从最初的工具中删除了21个项目(8个项目缺乏相关性,6个项目缺乏适当性,3个项目缺乏文字清晰度,4个项目冗余)。使用认知访谈(回顾性言语探究法)对由13个维度下的51个项目组成的最终工具的反应过程有效性进行了测试。在对30名参与者进行试点测试之前,对10名潜在参与者进行了测试-重新测试可靠性评估,以评估该工具的可靠性。结果:研究发现,如果项目被删除,Cronbachα对工具中51个项目中的任何一个以及13个维度都没有显示出显著的改善。该工具中51个项目的Cronbachα系数为0.95,13个维度的Cronbach'sα系数为0.87,表明该工具中的项目在这些维度下具有高度的可靠性。结论:初步研究证明了在三级护理医院使用这种新工具的可行性,同时表明了该工具的可靠性。然而,该工具需要使用更大的样本量和因子分析进行进一步评估,以验证试点研究的这些结果。
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引用次数: 0
Call for global leaders to improve their preparedness and response amidst changing dynamics of the coronavirus disease 2019 outbreak 呼吁全球领导人在2019年冠状病毒疫情不断变化的情况下加强准备和应对
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_15_20
S. Shrivastava, P. Shrivastava
The Corona Virus Disease-2019 (COVID-19) outbreak continues to increase in terms of reported cases, attributed deaths and global distribution since the detection of the first case in the Wuhan city of China. The important finding is that China has been successful in minimizing the incidence as well as attributed deaths, but an opposite trend has been observed in rest of the world. As cases have been reported even in those nations which are having a weak healthcare delivery system, we have to ensure that we are ready with a concerted, well-coordinated and a holistic response plan. The need of the hour is to recognize that no one is immune to infection and thus we have to do our part, as an individual, as a community and as a nation as well to protect people from this novel infection. In conclusion, the COVID-19 outbreak is a global public health emergency with a very high risk of transmission. It is extremely essential to improve our level of preparedness and mount a strong and well-coordinated response plan to contain the infection across the globe.
自中国武汉市发现首例病例以来,2019冠状病毒病(新冠肺炎)疫情在报告病例、归因死亡人数和全球分布方面继续增加。重要的发现是,中国成功地将发病率和归因死亡降至最低,但在世界其他地区观察到了相反的趋势。由于即使在那些医疗服务体系薄弱的国家也有病例报告,我们必须确保我们准备好制定一个协调一致、协调良好和全面的应对计划。现在的需要是认识到,没有人能免受感染,因此,作为个人、社区和国家,我们必须尽自己的一份力量,保护人们免受这种新型感染。总之,新冠肺炎疫情是一场全球突发公共卫生事件,传播风险非常高。至关重要的是,要提高我们的准备水平,制定强有力、协调良好的应对计划,以遏制全球范围内的感染。
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引用次数: 1
A population-based study on the burden of tobacco-related cancers in Kamrup urban district cancer registry of Assam, India 印度阿萨姆邦Kamrup市区癌症登记处烟草相关癌症负担的人群研究
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_72_19
J. Sharma, D. Barman, Arpita Sharma, M. Kalita, A. Kataki, Ranjan Lahon, Chinmoy Misra
Background: Tobacco use remains a serious and persistent national problem and is the leading preventable cause of cancer worldwide. At least 1.3 billion people worldwide use tobacco in some form and are responsible for causing mortality of approximately 6 million people annually from cancer and other diseases. Materials and Methods: Data collection is active with participation of different sources including major hospitals, diagnostic centers, state referral board, and birth and death registration centers within registry area as cancer is not notifiable in India. Results: In males, a total of 4794 cancer cases were registered in Kamrup urban district during the period from 2010 to 2014, out of which 2386 cases were tobacco-related cancers (TRCs), and in females out of 3767 cases, 944 were TRCs. In the North Eastern Region, head-and-neck cancer is common, and high use of tobacco is a risk factor in this region. The age-standardized rate (age-adjusted rate) per 100,000 population of TRCs in males is 99.9 and in females is 48.0. Conclusion: Knowledge of the incidence and pattern of TRCs is of paramount importance in planning and implementing measures for primary prevention of tobacco use which is a major step in cancer control.
背景:烟草使用仍然是一个严重和持久的国家问题,是全球癌症的主要可预防原因。全世界至少有13亿人以某种形式使用烟草,每年导致约600万人死于癌症和其他疾病。材料和方法:由于癌症在印度是不可申报的,数据收集工作正在积极进行,不同来源包括主要医院、诊断中心、国家转诊委员会以及登记区内的出生和死亡登记中心。结果:2010-2014年期间,卡姆鲁普市区共登记了4794例癌症男性病例,其中2386例为烟草相关癌症(TRCs),3767例女性中944例为TRCs。在东北地区,头颈部癌症很常见,大量使用烟草是该地区的一个危险因素。每100000名TRCs人群中男性的年龄标准化率(年龄调整率)为99.9,女性为48.0。结论:了解TRCs的发病率和模式对于制定和实施烟草使用初级预防措施至关重要,这是癌症控制的重要步骤。
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引用次数: 0
Different sources of information and their effects on contraceptives usage among female undergraduates in a Nigerian university 不同信息来源及其对尼日利亚一所大学女大学生避孕药具使用的影响
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_24_18
I. Abdul, A. Imohagene, L. Omokanye, K. Adesina, M. Oguntoye, G. Popoola
Aim: The aim is to determine whether there is a significant and or predictable effect of information sources on contraceptives and contraceptives usage among female undergraduates at the University of Ilorin, Ilorin, Nigeria. Design: The study design involves cross-sectional structured questionnaire-based. Setting: The university campus. Participants: One hundred and fifty-one females from 100 to 500 levels and studying varying courses were selected from the bursary list of students using a multistage random sampling method. Main Outcome Measures: Do sources of information have a significant and predictable relationship with contraceptives usage? Results: Most of the students were 20–24 years old (53.0%) with a mean age of 20.28 ± 2.20 years. Christianity was the most practiced religion (55.0%), while Yoruba, the predominant tribe (73.6%). Out of the 91.4% aware of contraceptives, only 51.0% had ever used contraception. The condom was the most typical (90.9%) contraceptive used. Teachers were the most reported source of information on contraception (20.1%) but were not statistically significant, followed closely by peers (15.9%), with only 14.95% coming from hospital sources. However, at the multivariate level, radio was four times a significant predictor of use of contraception among the students (odds ratio [OR] = 4.288. 95% confidence interval [CI] [1.106–16.633]) while television was two times a predictor (OR = 1.987. 95% CI [0.776–5.091]). Conclusion: Television and radio were found to have a significant and predictable impact on contraceptives usage, so promotion of contraceptive use should engage the media more when targeting university students. The university's local radio becomes highly recommended, and the upcoming university local television station in sexual health and contraception information dissemination for students. Implication Statement: The promotion of sexual and reproductive health, especially contraception, to prevent sexually transmitted diseases and unwanted pregnancy on the campus of higher institutions are incredibly important. This study is contributing to understanding the ways and means of going about this demanding and evolving task.
目的:目的是确定信息来源对尼日利亚伊洛林伊洛林大学女本科生避孕药具和避孕药具使用是否有显著或可预测的影响。设计:研究设计包括基于横断面的结构化问卷。背景:大学校园。参与者:采用多阶段随机抽样方法,从助学金学生名单中选择151名来自100至500个级别并学习不同课程的女性。主要结果衡量标准:信息来源与避孕药具的使用是否有显著和可预测的关系?结果:大多数学生年龄在20-24岁(53.0%),平均年龄为20.28±2.20岁。基督教是最信奉的宗教(55.0%),而约鲁巴族是占主导地位的部落(73.6%)。在91.4%的避孕者中,只有51.0%的人使用过避孕药具。避孕套是最典型的避孕方法(90.9%)。据报道,教师是避孕信息最多的来源(20.1%),但在统计上并不显著,其次是同龄人(15.9%),只有14.95%来自医院。然而,在多变量水平上,无线电是学生避孕的四倍重要预测因素(比值比[OR]=4.288)。95%置信区间[CI][1.106–16.633]),而电视是两倍的预测因子(OR=1.987。95%置信区间[7.776–5.091])。结论:电视和广播对避孕药具的使用有显著且可预测的影响,因此在针对大学生时,宣传避孕药具使用应更多地吸引媒体。该大学的地方电台成为强烈推荐,并即将在该大学的当地电视台为学生传播性健康和避孕信息。含义声明:促进性健康和生殖健康,特别是避孕,以防止高等院校校园内的性传播疾病和意外怀孕,这一点非常重要。这项研究有助于理解完成这项艰巨而不断发展的任务的方式和方法。
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引用次数: 0
Knowledge, attitude, and practices about biomedical waste management as per 2016 rules among resident doctors and nursing staff in a tertiary care specialty hospital: A cross-sectional study 三级护理专科医院住院医生和护理人员根据2016年规则对生物医学废物管理的知识、态度和实践:一项横断面研究
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_73_20
Pranjal Dey, B. Das
Background: During the health-care delivery process, healthcare establishments generate hazardous bio-medical wastes (BMWs) which need for appropriate handling and management to prevent environmental and public health hazard. Different healthcare professionals should have adequate knowledge, attitudes, and practices with respect to BMW management. Honorable Supreme Court of India had led down the guidelines on BMW (Management and Handling) Rules in 1998, which was amended in 2016 by the Environment ministry. Objective: To assess knowledge, attitude, and practices regarding BMW management among the resident doctors and nursing staff in a tertiary care specialty teaching hospital as per new BMW Management Rules, 2016. Study Design: This was an institution based cross-sectional study. Methods: Predesigned, pretested, structured questionnaires were administered on fifty resident doctors and fifty nursing staff of the hospital with their prior consent. Data were analyzed using SPSS-25. Chi-square test and independent-sample t-test were applied for the analysis. Results: Both groups had adequate and comparable knowledge about BMW management. The nursing group had significantly more favorable attitude and adequate practice in comparison to resident doctors (P = 0.0001). There was lack of adequate training in both the groups significantly more in resident doctors. Regarding practices, resident doctors had more inadequate practice regarding handling, segregation, disposal, reporting, and record maintenance of BMW than nursing staff. Conclusion: Nursing staff have a better attitude and good practice than the resident doctors about BMW management. There should be a regular training program regarding BMW management for both the cadres of health-care workers.
背景:在医疗保健提供过程中,医疗保健机构会产生危险的生物医疗废物,需要进行适当的处理和管理,以防止对环境和公共健康造成危害。不同的医疗保健专业人员应该对宝马管理有足够的知识、态度和实践。尊敬的印度最高法院于1998年制定了《宝马(管理和处理)规则》指南,该指南于2016年由环境部修订。目的:根据2016年新的《宝马管理规则》,评估三级护理专业教学医院住院医生和护理人员对宝马管理的知识、态度和实践。研究设计:这是一项基于机构的横断面研究。方法:在征得住院医师和护理人员同意的情况下,对50名住院医师和50名护理人员进行预先设计、预先测试和结构化问卷调查。使用SPSS-25对数据进行分析。采用卡方检验和独立样本t检验进行分析。结果:两组在宝马管理方面都有足够且可比的知识。与住院医生相比,护理组的态度和实践明显更为积极(P=0.0001)。两组都缺乏足够的培训,住院医生的情况更为严重。在实践方面,住院医生在宝马车的处理、隔离、处置、报告和记录维护方面的实践比护理人员更为不足。结论:护理人员对宝马车管理的态度和实践均优于住院医生。应该为医护人员的干部制定一个关于宝马管理的定期培训计划。
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引用次数: 4
A rare presentation of nasal tuberculosis 鼻结核的罕见表现
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_26_19
S. Swain, I. Behera
Tuberculosis is a chronic granulomatous disease common in developing countries resulting in significant morbidity and mortality. It has varied clinical presentations, and it varies from common pulmonary tuberculosis to the rare lone like tuberculosis of the nose involving the columella like in this case. Primary nasal tuberculosis is an extremely rare clinical entity even in developing countries where tuberculosis is common. Early diagnosis and treatment will definitely reduce the morbidity of the disease. It becomes more difficult to diagnose if presenting with nonspecific symptoms which are not associated with classical nasal tuberculosis. Here, we report the diagnosis and treatment of a rare case of primary nasal tuberculosis in the columella region.
结核病是发展中国家常见的一种慢性肉芽肿性疾病,发病率和死亡率很高。它的临床表现多种多样,从常见的肺结核到罕见的鼻子结核,包括小柱,就像这个病例。原发性鼻结核是一种极其罕见的临床实体,即使在发展中国家,结核病是常见的。早期诊断和治疗一定会降低疾病的发病率。如果出现与经典鼻结核无关的非特异性症状,则更难诊断。在此,我们报告一例罕见的原发性鼻小柱区结核的诊断和治疗。
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引用次数: 1
Distancing of importation: Observation on imported COVID patients 隔离输入:境外输入病例观察
Q4 Medicine Pub Date : 2020-01-01 DOI: 10.4103/jms.jms_58_20
S. Yasri, V. Wiwanitkit
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引用次数: 0
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JMS - Journal of Medical Society
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