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Knowledge, attitudes, and practice to COVID 19 infection among outpatients attending a general medicine department 普通内科门诊患者对COVID - 19感染的知识、态度和行为
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_79_22
Amita Jacob, J. Rebekah, R. Carey
Background and Objectives: We aimed to assess the knowledge, attitudes, and practices regarding COVID-19 among general medicine outpatients. Materials and Methods: We recruited people attending a general medicine outpatient department of a tertiary hospital. We assessed knowledge, attitudes, and practices toward COVID-19 using a specially designed questionnaire. Results: Two hundred and sixty-eight participants were recruited. The study documented high knowledge, positive attitude, and good practice among patients and their relatives. Knowledge was significantly associated with higher education (odds ratio [OR] = 2.87; 95% confidence interval [CI] = 1.127.36; P = 0.029) and the use of the Internet as a source of information about COVID-19 (OR = 5.17; 95% CI = 2.2611.85; P = 0.000). However, Internet use (OR = 0.23; 95% CI = 0.100.54; P = 0.001) was associated with a more negative attitude. Good practice was associated with high levels of knowledge (OR = 2.20; 95% CI = 1.223.96; P = 0.009), a positive attitude (OR = 2.31; 95% CI = 1.134.71; P = 0.022), and a professional or semi-professional occupation (OR = 2.80; 95% CI = 1.077.32; P = 0.036). Residence outside of the district (OR = 2.79; 95% CI = 1.077.32; P = 0.036) was associated with better practice related to COVID-19 suggesting people who travel greater distances for health care may be more motivated at maintaining better practice. Conclusion: The study found that good practice in relation to COVID-19 was associated with higher levels of knowledge, a positive attitude, professional occupation, and distance traveled to reach hospital.
背景与目的:本研究旨在了解全科门诊患者对COVID-19的知识、态度和行为。材料和方法:我们招募了在某三级医院普通科门诊就诊的患者。我们使用专门设计的问卷评估了对COVID-19的知识、态度和做法。结果:共招募了268名参与者。该研究记录了患者及其家属的高知识、积极态度和良好行为。知识与高等教育显著相关(优势比[OR] = 2.87;95%置信区间[CI] = 1.127.36;P = 0.029)和使用互联网作为COVID-19信息来源(OR = 5.17;95% ci = 2.2611.85;P = 0.000)。然而,互联网使用(OR = 0.23;95% ci = 0.100.54;P = 0.001)与更消极的态度相关。良好的实践与高水平的知识相关(OR = 2.20;95% ci = 1.223.96;P = 0.009),积极态度(OR = 2.31;95% ci = 1.134.71;P = 0.022),专业或半专业职业(or = 2.80;95% ci = 1.077.32;P = 0.036)。区外居住(OR = 2.79;95% ci = 1.077.32;P = 0.036)与COVID-19相关的更好实践相关,这表明长途跋涉的人可能更有动力保持更好的实践。结论:研究发现,与COVID-19相关的良好做法与更高的知识水平、积极的态度、专业的职业和到医院的距离有关。
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引用次数: 0
Anxiety, depression and stress among female medical students during the second wave of the COVID-19 pandemic and their association with family functioning, coping and personality 第二波COVID-19大流行期间女医学生的焦虑、抑郁和压力及其与家庭功能、应对和个性的关系
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_81_22
G. Mallaram, Subahani Shaik, D. Kattula
Background and Aims: This research examined anxiety, depression, and stress levels in female medical students during the second wave of coronavirus disease 2019 (COVID-19) and the association between these variables and family functioning, coping, and personality factors. Materials and Methods: The cross-sectional online observational study was conducted using Google Forms. Anxiety, depression, and stress were assessed using the Depression, Anxiety, and Stress Scale (DASS-21), family functioning using Family Adaptability, Partnership, Growth, Affection, and Resolve, coping using Brief COPE, and personality using the Big Five Inventory 10-item version. Results: Out of 750 students, 500 thoroughly responded to the online survey. Based on the DASS-21 scores, 57.6% of participants had some stress, 63.4% had some anxiety, and 54.8% had some degree of depression. Anxiety, depression, and stress were highly correlated with each other. Stress, anxiety, and depression were weakly linked with problem-focused coping, moderately correlated with emotion-focused coping, and strongly correlated with avoidant coping. Better family functioning was associated with lesser self-reported stress, anxiety, and depression. Neuroticism was associated with higher anxiety, depression, and stress, while agreeableness and conscientiousness were with lower psychological distress. Conclusion: High level of psychological suffering was prevalent among medical students during the COVID-19 pandemic. Their anxiety, depression, and stress must be adequately managed.
背景与目的:本研究调查了2019年第二波冠状病毒病(COVID-19)期间女医学生的焦虑、抑郁和压力水平,以及这些变量与家庭功能、应对和人格因素之间的关系。材料和方法:采用Google表格进行横断面在线观察研究。使用抑郁、焦虑和压力量表(DASS-21)评估焦虑、抑郁和压力,使用家庭适应性、伙伴关系、成长、情感和决心评估家庭功能,使用简短COPE评估应对,使用大五量表10项版本评估人格。结果:在750名学生中,有500人对在线调查进行了彻底的回应。根据das -21评分,57.6%的参与者有一定的压力,63.4%的参与者有一定的焦虑,54.8%的参与者有一定程度的抑郁。焦虑、抑郁和压力是高度相关的。压力、焦虑和抑郁与以问题为中心的应对呈弱相关,与以情绪为中心的应对呈中等相关,与回避型应对呈强相关。更好的家庭功能与较少的自我报告的压力、焦虑和抑郁有关。神经质与较高的焦虑、抑郁和压力有关,而随和和尽责性与较低的心理困扰有关。结论:新冠肺炎疫情期间医学生心理痛苦程度较高。他们的焦虑、抑郁和压力必须得到适当的管理。
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引用次数: 1
Delving deeper into the transformative landscape of health care 深入研究医疗保健的变革前景
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_122_23
SheikhMohd Saleem, ShahSumaya Jan
Sir, I am compelled to delve into the discourse ignited by the editorial “Changing Contour of Healthcare,”[1] which brilliantly navigates the tides of change that are shaping the very essence of medical practice. The editorial meticulously unveils the intricate interplay between technological advancements, societal shifts, and their reverberations across clinical practice, medical education, research, and governance. The editorial appropriately cites the philosopher Heraclitus, reminding us that change is not merely a transient occurrence but the very essence of existence. The COVID-19 pandemic, in its grim wake, has become a harbinger of profound transformations that have propelled health care into an era of unprecedented metamorphosis. The pandemic, as a crucible of necessity, has not only fast-tracked the adoption of telemedicine, wearable devices, and advanced therapies but also ignited a blazing momentum toward the fusion of artificial intelligence (AI) with medical science. The editorial's exploration of the ethical dimensions inherent in this new realm is pivotal. AI, epitomized by the advent of ChatGPT, has demonstrated its prowess in surpassing traditional benchmarks in medical licensing examinations, thereby igniting queries that transcend mere fascination. The pertinence of ethics, validation, and sustainability in this transformation is paramount. While AI has cast a compelling spell over medical education and practice, the validity of its insights, the preservation of patient privacy, and the potential for exacerbating disparities necessitate unflinching scrutiny. While echoing the editorial's sentiments, we wish to introduce some additional dimensions to the dialog: 1. Ethics and humanism in AI: As AI algorithms delve deeper into medical diagnostics and prognostics, we must not relinquish the ethical foundation and humanistic ethos that underpin medical practice. The symbiotic relationship between AI's computational prowess and the healer's empathic touch is a testament to the potential for collaboration rather than replacement[2] 2. Resilient systems and preparedness: The editorial rightly extols the value of population-based research in predicting health-care trends and enhancing institutional preparedness. The COVID-19 pandemic has unveiled the fragility of existing health-care systems. Nurturing robust, adaptive frameworks that can pivot in response to emerging challenges becomes paramount in safeguarding public health[3] 3. Global collaborations in AI research: As the nexus between AI and health-care expands, fostering cross-disciplinary and global collaborations becomes nonnegotiable. The challenges posed by AI-driven innovations, ranging from algorithmic biases to data integrity, transcend geographical boundaries. It is our collective responsibility to forge international partnerships that harness AI's potential for collective human benefit[4] 4. Innovations in medical education: The intersection of AI and medical education n
先生,我不得不深入研究社论“改变医疗保健的轮廓”所引发的讨论,[1]它出色地驾驭了塑造医疗实践本质的变革浪潮。这篇社论细致地揭示了技术进步、社会变革之间错综复杂的相互作用,以及它们在临床实践、医学教育、研究和治理方面的影响。这篇社论恰当地引用了哲学家赫拉克利特的话,提醒我们变化不仅仅是短暂的事件,而是存在的本质。2019冠状病毒病大流行的严峻后果已成为一种深刻变革的先兆,这种变革将医疗保健推向了一个前所未有的蜕变时代。疫情作为必要的考验,不仅加速了远程医疗、可穿戴设备、先进疗法的采用,而且点燃了人工智能(AI)与医学融合的火热势头。这篇社论对这个新领域中固有的伦理维度的探索是至关重要的。以ChatGPT的出现为代表的人工智能,已经证明了它在医疗执照考试中超越传统基准的能力,从而引发了超越单纯迷恋的疑问。在这种转变中,伦理、有效性和可持续性的相关性是至关重要的。虽然人工智能对医学教育和实践产生了令人信服的影响,但其见解的有效性、对患者隐私的保护以及加剧差距的可能性,都需要进行坚定的审查。在回应社论观点的同时,我们希望在对话中引入一些额外的维度:1。人工智能中的伦理和人文主义:随着人工智能算法深入医疗诊断和预测,我们不能放弃支撑医疗实践的伦理基础和人文主义精神。人工智能的计算能力和治疗者的移情接触之间的共生关系证明了合作而不是替代的潜力[2]2。弹性系统和准备:社论正确地赞扬了以人口为基础的研究在预测卫生保健趋势和加强机构准备方面的价值。COVID-19大流行暴露了现有卫生保健系统的脆弱性。培育强大的适应性框架,以应对新出现的挑战,这对于保障公共卫生至关重要[3]。人工智能研究的全球合作:随着人工智能与卫生保健之间联系的扩大,促进跨学科和全球合作变得不容置疑。人工智能驱动的创新带来的挑战,从算法偏见到数据完整性,超越了地理界限。建立国际伙伴关系,利用人工智能的潜力为人类集体造福是我们的共同责任[4]4。医学教育的创新:人工智能和医学教育的交叉需要全面的范式转变。虽然人工智能可以增加程序性知识,但批判性思维、临床推理和富有同情心的患者互动仍然是神圣不可侵犯的。将人工智能作为增强而不是取代这些核心能力的工具,具有巨大的前景。[5]总之,这篇社论是一个号角,呼吁我们拥抱变化,将其作为持续改进的催化剂。它召唤着我们,医学科学的守护者,带着智慧、创新和道德的融合,去穿越未知的领域。当我们在这一变革性的环境中游弋时,我们努力的指南针必须以对人类福祉的深刻奉献来校准。在这些反思的强化下,这篇社论作为话语的基石,回响着,指引着我们走向一个未来,在这个未来,变革不仅被视为一种常态,而且被视为一种无与伦比的进步渠道。财政支持及赞助无。利益冲突没有利益冲突。
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引用次数: 0
Internet addiction and its impact on medical education in India: A meta-analysis 网络成瘾及其对印度医学教育的影响:一项荟萃分析
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_79_23
VenkataVenu Gopala Raju Srijampana, AnandaReddy Endreddy, Chaitanya Gujjarlapudi, AshaParveen Sayyad
Background: In the recent past, Internet addiction has become a topic of concern, with studies reporting its association with various negative consequences, such as decreased academic performance, compromised mental health, impaired social functioning and reduced quality of life. Despite the growing concern about the impact of internet addiction on medical education in India, the existing literature on this topic is limited and lacks a comprehensive synthesis of evidence. Aims and Objectives: This meta-analysis aims to offer a significant understanding regarding the correlation between internet addiction and medical education. Materials and Methods: The present meta-analysis followed the guidelines by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for conducting as well as, reporting the meta-analyses. Studies conducted in various regions of India were included and were published between 2010 and 2022. Results and Analysis: The pooled effect size for academic performance, as measured by exam scores was SMD -0.36 (95% CI: -0.52 to -0.21), indicated to have a significant detrimental effect of internet addiction on academic performance. For mental health indicators, the pooled effect size was found to be having a SMD 0.45 (95% CI: 0.22 to 0.69, P<0.001), indicating a significant positive association. Conclusion: Internet addiction is associated with various negative consequences, such as decreased academic performance, increased risk of mental health disorders, and impaired interpersonal relationships. The results also highlight the need for awareness, prevention, and intervention programs targeted at addressing internet addiction among the students in medical education.
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引用次数: 0
A rare cause of acute breathlessness in a nulliparous female 在未生育的雌性中引起急性呼吸困难的罕见原因
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_64_23
Vijayan Sharmila, Padmapriya Balakrishnan
Dyspnea in a woman of reproductive age group is a common condition encountered in clinical practice. Neoplasms of the female genital tract may also present with dyspnea creating diagnostic dilemma. A detailed history and thorough evaluation helps to clinch the diagnosis in such cases. We report the case of a reproductive-aged nulliparous woman who presented with dyspnea having multiple pulmonary solid nodules diagnosed with invasive mole by histopathology.
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引用次数: 0
The utility of an electrocardiogram in high-, intermediate-, and low-risk patients presenting with chest pain to emergency department 心电图在急诊科出现胸痛的高、中、低危患者中的应用
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_102_22
M. Sanjay, Anju S. Kurien, Merin Abraham, Abraham Speedie
Background: In emergency department (ED), though electrocardiogram (ECG) is obtained for both typical and atypical chest pain, at certain times, it is overutilized even in patients with low-risk factors for acute coronary syndrome (ACS). This study aimed to assess the utility of an ECG in patients presenting with chest pain to the ED. Materials and Methods: This prospective study included patients presenting with chest pain to the ED during August and September 2018. Following their initial assessment at triage, patients were grouped into high-, intermediate- and low-risk categories based on their risk factors for an ACS. ECGs were acquired and categorized into ACS and non-ACS pattern and their utility in each group was assessed. Results: This study cohort contains 313 patients with a male predominance 59.1%. The mean age was 52.6 ± 15.2 years. Typical chest pain was prominent in 95 (30.4%) patients. The incidence of ischemic and structural heart diseases was 53 (16.9%) and 31 (9.9%), respectively. ACS was diagnosed in 92 (29.3%) patients; among them, ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina were noted to be 51 (16.3%), 27 (8.6%), and 14 (4.5%), respectively. The incidence of ACS based on risk category classification was as follows: high risk 38.9% (44/113) and intermediate risk 33.8% (48/142) and no patients in low risk had ACS. Conclusions: ECG though a useful screening test to diagnose ACS, should be used judiciously in patients with low risk of ACS to optimally utilize the limited resources in ED.
背景:在急诊科(ED),虽然典型胸痛和非典型胸痛都需要心电图(ECG),但在某些时候,即使是低危险因素的急性冠脉综合征(ACS)患者也会过度使用心电图(ECG)。本研究旨在评估心电图在急诊科胸痛患者中的应用。材料和方法:本前瞻性研究包括2018年8月至9月期间出现胸痛的急诊科患者。在分诊时进行初步评估后,根据ACS的危险因素将患者分为高、中、低风险类别。获得心电图并将其分为ACS型和非ACS型,并评估其在每组中的效用。结果:本研究共纳入313例患者,男性占59.1%。平均年龄52.6±15.2岁。95例(30.4%)患者典型胸痛突出。缺血性心脏病53例(16.9%),结构性心脏病31例(9.9%)。92例(29.3%)患者被诊断为ACS;其中st段抬高型心肌梗死(STEMI) 51例(16.3%),非st段抬高型心肌梗死(NSTEMI) 27例(8.6%),不稳定型心绞痛14例(4.5%)。按危险分类ACS发生率为:高危38.9%(44/113),中危33.8%(48/142),低危无ACS发生。结论:心电图虽然是诊断ACS的有效筛查试验,但在低风险的ACS患者中应谨慎使用,以充分利用有限的ED资源。
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引用次数: 0
Streamlining the process of assessment of faculty development programs targeting medical education 精简针对医学教育的教师发展计划的评估过程
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_81_23
SaurabhRamBihariLal Shrivastava, Rasdita Nurhidayati
Amidst the major reforms occurring in the medical education sector and the norms pertaining to the training of each faculty member training in medical education, a significant rise even in the field of medical education pertaining to Faculty Development Programs (FDPs) has been observed. Nevertheless, the mere production of a certificate of attendance should not be considered an indicator of faculty development in the medical education arena. It is high time that a set of criteria should be formulated to assess the faculty development and the entire thing should be streamlined through systematic assessments. To conclude, it is high time that we not only emphasize on faculty development but also on the assessment of these FDPs to assess the effectiveness of each of them and link the same with the growth of the institution and the betterment of society as a whole.
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引用次数: 0
Morphometric analysis of dry human patella – A cross-sectional observational study from Kashmir, North India 干人类髌骨的形态计量学分析-来自印度北部克什米尔的横断面观察研究
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_21_23
ShahSumaya Jan, MubashirYousuf Syed, SheikhMohd Saleem
Background: The kneecap, also called the patella, is located in front of the knee joint and protects it from injury. It is the most prominent sesamoid bone of the body and is embedded in the quadriceps tendon. The purpose of this study is to perform a detailed morphometric examination of the patella and compare it to specimens from the right and left sides of the patella. Methods: In this cross-sectional observational study, 40 dried patellae were collected from the Department of Anatomy, Government Medical College, Srinagar, of which 21 were right-sided and 19 were left-sided specimens. Height, width, and thickness of the patella; length and width of the articular facets on the medial and lateral sides; and length of the central ridge were among the parameters examined in the study. Results: The mean height, width, and thickness of the patella specimens were 4.10 cm, 2.01 cm, and 4.10 cm, respectively, according to morphometric analysis. The dimensions of the articular facet on the lateral side were found to be statistically different from the dimensions of the articular facet on the medial side, with P = 0.05 considered statistically significant. According to Koyunco's classification, 87.5% of the patella specimens belonged to type B. Conclusion: The morphometric analysis of the patella in this study may help to design implants for reconstruction and guide orthopedic surgeons in reconstructive and fixation surgery of the patella.
{"title":"Morphometric analysis of dry human patella – A cross-sectional observational study from Kashmir, North India","authors":"ShahSumaya Jan, MubashirYousuf Syed, SheikhMohd Saleem","doi":"10.4103/cmi.cmi_21_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_21_23","url":null,"abstract":"Background: The kneecap, also called the patella, is located in front of the knee joint and protects it from injury. It is the most prominent sesamoid bone of the body and is embedded in the quadriceps tendon. The purpose of this study is to perform a detailed morphometric examination of the patella and compare it to specimens from the right and left sides of the patella. Methods: In this cross-sectional observational study, 40 dried patellae were collected from the Department of Anatomy, Government Medical College, Srinagar, of which 21 were right-sided and 19 were left-sided specimens. Height, width, and thickness of the patella; length and width of the articular facets on the medial and lateral sides; and length of the central ridge were among the parameters examined in the study. Results: The mean height, width, and thickness of the patella specimens were 4.10 cm, 2.01 cm, and 4.10 cm, respectively, according to morphometric analysis. The dimensions of the articular facet on the lateral side were found to be statistically different from the dimensions of the articular facet on the medial side, with P = 0.05 considered statistically significant. According to Koyunco's classification, 87.5% of the patella specimens belonged to type B. Conclusion: The morphometric analysis of the patella in this study may help to design implants for reconstruction and guide orthopedic surgeons in reconstructive and fixation surgery of the patella.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"309 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134882506","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}
引用次数: 0
Proposing a framework to plan and implement problem based learning sessions for undergraduate medical students 提出一个框架,计划和实施基于问题的医学本科生学习课程
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_100_22
S. Shrivastava, P. Shrivastava
The process of transforming a freshly joined medical student into a competent medical graduate is a complex one. It is an indisputable fact that having good knowledge (cognitive domain) is crucial for better performance in psychomotor and affective domains. In the global vision to improve health-care delivery, it is crucial that medical students are trained in critical thinking, clinical reasoning, and problem-solving skills. Problem-based learning (PBL) is a student-centered teaching–learning strategy, which ensures the active engagement of learners. As students get an opportunity to perform a literature search or explore different learning resources, they attempt to learn through self-directed learning, and in the process understand the need to be a lifelong learner for a successful clinical practice in future. In conclusion, PBL session is an effective way to inculcate complex cognitive skills among medical students, and thus, it is quite essential that medical colleges should initiate and implement PBL in their settings after proper planning and with the support of the Medical Education Unit.
将一名刚入职的医科学生转变为一名称职的医科毕业生是一个复杂的过程。拥有良好的知识(认知领域)对于在精神运动和情感领域取得更好的表现至关重要,这是一个不争的事实。在改善医疗保健服务的全球愿景中,对医科学生进行批判性思维、临床推理和解决问题技能的培训至关重要。基于问题的学习是一种以学生为中心的教学策略,它保证了学习者的积极参与。当学生有机会进行文献检索或探索不同的学习资源时,他们会尝试通过自主学习来学习,并在这个过程中了解到为了将来成功的临床实践,需要成为一个终身学习者。综上所述,PBL课程是向医学生灌输复杂认知技能的有效途径,因此,在医学教育单位的支持下,医学院应在适当的规划后在其环境中开展和实施PBL课程。
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引用次数: 0
Understanding catastrophic healthcare expenditures - Implications for research 了解灾难性医疗保健支出-对研究的影响
Pub Date : 2023-01-01 DOI: 10.4103/cmi.cmi_61_22
H. Avirneni, S. Swaminathan, A. John
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引用次数: 0
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