The National medical journal of India最新文献

Background Reflective practice is an integral component of continuing professional development. However, assessing the written narration is complex and difficult. Rubric is a potential tool that can overcome this difficulty. We aimed to develop, validate and estimate inter-rater reliability of an analytical rubric used for assessing reflective narration. Methods A triangulation type of mixed-methods design (Qual-Nominal group Technique, Quan-Analytical follow-up design and Qual-Open-ended response) was adopted to achieve the study objectives. Faculties involved in the active surveillance of Covid-19 participated in the process of development of assessment rubrics. The reflective narrations of medical interns were assessed by postgraduates with and without the rubric. Steps recommended by the assessment committee of the University of Hawaii were followed to develop rubrics. Content validity index and inter-rater reliability measures were estimated. Results An analytical rubric with eight criteria and four mastery levels yielding a maximum score of 40 was developed. There was a significant difference in the mean score obtained by interns when rated without and with the developed rubrics. Kendall's coefficient of concordance, which is a measure of concordance of scorers among more than two scorers, was higher after using rubrics. Conclusion Our attempt to develop an analytical rubric for assessing reflective narration was successful in terms of the high content validity index and better inter-rater concordance. The same process can be replicated to develop any such analytical rubric in the future.

Background Ayurveda, the Indian system of medicine, has been practised in India since ages. We evaluated the overall awareness regarding Ayurveda among patients attending two specialty clinics at a tertiary care institute. Methods We did a cross-sectional study on patients attending the cardiology and neurology clinics at a tertiary care hospital in India. We conducted this paper-based survey using a standardized, validated questionnaire. Statistical analysis was performed using STATA version 14.2. Results Three hundred and ninety-seven patients agreed to participate in the study. Their mean (SD) age was 45.65 (15.02) years. Among them 68.5% were men and 56.9% were from urban areas. Participants perceived that Ayurveda comprised herbal drugs (77.6%), metallic/herbo-mineral preparations (44.3%), Panchakarma therapy (22.2%) and personalized medicine (37.8%). Principal sources of information were TV promotional programmes (34.7%) and newspaper advertisements (13.9%). Nearly two-thirds (63%) of participants opined that Ayurveda is effective in chronic disorders. Although only 9.1% of participants reported the use of Ayurvedic medicines, 89.2% believed it would be beneficial if the All India Institute of Medical Sciences (AIIMS), New Delhi had Ayurveda services. Three-fourths (75.8%) of respondents were interested to participate in research studies integrating Ayurveda with modern medicine. Conclusion Imprecise knowledge and awareness towards Ayurveda appears to prevail in addition to the low practice among the patients surveyed. We found imprecise knowledge of Ayurvedic therapies and its low usage among patients attending specialized OPDs in a tertiary care hospital. The major source of information reported was promotional advertisements in the print and electronic media. Our survey shows a need for awareness programmes for general public at various levels.

Background . To mark the 130th birth anniversary of Japanese writer Ryunosuke Akutagawa (1892-1927), I revisit his suicide (as recorded by his hand) in comparison to that of his junior contemporaries, who also chose a similar mode of death. Data sources . Two works of Akutagawa, namely Tenkibo (1926: Death Register) and Aru Ahono Issho (1927: The Life of a Stupid Man) in English translation of Jay Rubin were used as the main sources, in addition to published literature about his creativity. Results . In his final work, The Life of a Stupid Man, completed in the penultimate month before suicide, 7 among the 51 brief descriptions, Akutagawa had described his thoughts on illness and death, in addition to visiting his biological mother in a lunatic asylum, and studying a cadaver for his famous short story 'Rashomon'. These descriptions offer a fascinating perspective on Akutagawa's state of mind, before his suicide. Akutagawa's suicide is also compared with the suicides of five other renowned Japanese writers (Osamu Dazai, Yasunari Kawabata, Misuzu Kaneko, Yukio Mishima and Juzo Itami). Conclusion . Before his suicide, doctors offered Akutagawa various diagnoses: 'insomnia, gastric hyperacidity, gastric atony, dry pleurisy, neurasthenia, chronic conjunctivitis, brain fatigue'. Though it is uncertain, what percentage of hereditary factor(s) played a role, why the practitioners of the medical profession in 1920s Japan failed to save the life of this creative individual still remains a question.

Background . We assessed the balance between the number of publications required by medical teachers and the publication space available in the Indian medical journals. Methods . The Medical Council of India (MCI) website, its guidelines and documents were searched and we extracted data on the number of medical colleges, undergraduate and postgraduate seats and faculty requirement. The required number of assistant professors and associate professors was calculated. The publication requirements were estimated according to MCI's February 2020 guidelines. A publication which satisfied the above guidelines for promotion was counted as 'eligible publication'. Indian medical journals indexed in any of the MCI-permitted databases were identified, and the number of eligible articles in them in 2019 was counted. Results . India has a total of 79 798 MBBS seats, 33 025 postgraduate seats and 4231 superspecialty seats in MCI-certified medical institutions and to teach them 35 285 assistant professors and 23 116 associate professors are required. Assuming that each publication could serve a maximum of 3 teachers, we will need approximately 50 696 eligible publications in the next 7 years. A search of applicable databases, identified 162 unique Indian medical journals of which 79 were indexed in PubMed/PubMed Central. Among the remaining 63 were indexed in DOAJ, 14 in EMBASE, 3 in Scopus and 3 were indexed only in WOSSCIE. These journals cumulatively published a total of 8508 eligible publications in 2019. Conclusion . The publication space in Indian medical journals is limited, thus there is a need to have a national medical repository such as MedRxiv to prevent publication in predatory journals.