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Awareness of antibiotic resistance among medical students in Kerala State, India: A cross-sectional study 印度喀拉拉邦医科学生抗生素耐药性意识:一项横断面研究
Pub Date : 2022-10-01 DOI: 10.4103/cmi.cmi_69_22
A.Josephine Reena, Abraham M. Ittyachen
Background: Antibiotic resistance is a natural phenomenon, but its misuse has expedited resistance. One of the best measures to tackle antibiotic resistance in the community would be to educate medical students and create awareness among them regarding antibiotic resistance. The objectives of this study were to assess the level of awareness of antibiotic resistance among undergraduate medical students and to determine the factors affecting the awareness. Materials and Methods: This is a cross-sectional study using a structured questionnaire among undergraduate medical students from the 1st year to the 4th year. Results: Three hundred and fifty-four undergraduate medical students from the 1st year to the 4th year were enrolled. More than 80% of students were from the 18–22-year age group, and more than half were female. Only 56.2% of participants had adequate awareness of antibiotic resistance. The academic year was not significantly associated with the awareness. Age and gender also had no significant association. Parent's education, parent's occupation, parents being medical practitioners and family income also had no significant association. Conclusion: Awareness levels regarding antibiotic resistance among medical students were slightly above 50%. Moreover, it seems to be a worldwide phenomenon too. Further studies are recommended to evaluate the practices and attitudes regarding the same. A “catch them young” policy would be a good step to tackle antimicrobial resistance at its inception itself. Moreover, it should start at the local level. Similar studies can be conducted among medical practitioners and health-care workers and at the community level.
背景:抗生素耐药是一种自然现象,但滥用抗生素加速了耐药性。解决社区抗生素耐药性的最佳措施之一是教育医学生并提高他们对抗生素耐药性的认识。本研究的目的是评估医学生对抗生素耐药性的认知水平,并确定影响认知的因素。材料与方法:本研究为横断面研究,采用结构化调查问卷,调查对象为一年级至四年级的医科本科生。结果:招收一年级至四年级医学生354人。超过80%的学生年龄在18 - 22岁之间,其中一半以上是女性。只有56.2%的参与者对抗生素耐药性有足够的认识。学年与这种意识没有显著关联。年龄和性别也无显著相关性。父母受教育程度、父母职业、父母是否执业医师与家庭收入也无显著相关。结论:医学生对抗生素耐药性的知晓率略高于50%。此外,这似乎也是一个世界性的现象。建议进行进一步的研究,以评估有关这方面的做法和态度。一项“抓住他们年轻”的政策将是在抗菌素耐药性开始时解决它的一个很好的步骤。此外,它应该从地方层面开始。可以在医生和保健工作者之间以及在社区一级进行类似的研究。
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引用次数: 0
Marfan syndrome 马凡氏综合症
Pub Date : 2022-10-01 DOI: 10.4103/cmi.cmi_53_22
Arihant Seth, Ajay Mathur, Nitish Mathur, H. Pahadiya
Because connective tissue is found throughout the body, Marfan syndrome can affect many systems, often causing abnormalities in the heart, blood vessels, eyes, bones, and joints. The two primary features of Marfan syndrome are vision problems caused by a dislocated lens (ectopia lentis) in one or both eyes and defects in the large blood vessel that distributes blood from the heart to the rest of the body (the aorta). The aorta can weaken and stretch, which may lead to a bulge in the blood vessel wall (an aneurysm). Stretching of the aorta may cause the aortic valve to leak, which can lead to a sudden tearing of the layers in the aorta wall (aortic dissection). Aortic aneurysm and dissection can be life threatening.
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引用次数: 0
Is it one or two? 是一个还是两个?
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_48_22
R. Iyadurai, O. Abraham
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引用次数: 0
Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes at a tertiary care hospital in Jammu Region (Jammu and Kashmir), India 印度查谟地区(查谟和克什米尔)一家三级保健医院住院糖尿病患者中未确诊的糖尿病视网膜病变患病率
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_16_22
Arjumand Nazir, F. Wani, A. Jabeen
Background: One of the most devastating consequences of diabetes is diabetic retinopathy (DR), a condition that poses significant financial and health-care burdens on individuals, health-care systems, and the global economy. This study aims to estimate the prevalence of DR in the inpatient diabetic population in the tertiary care hospital of the Jammu region (Jammu and Kashmir). Methods: This cross-sectional study had men and women over 18 years admitted to Government Medical College, Jammu with type 1 or type 2 diabetes based on a previous physician diagnosis or hemoglobin A1C ≥6.5% (48 mmol/mol) and were eligible to participate. The exclusion criteria included type 1 diabetes diagnosed within the past 5 years. In addition, data on secondary risk factors for retinopathy were collected, such as duration, hemoglobin A1C, and associated comorbidities. Results: Seventy-eight patients with a known diagnosis of diabetes mellitus were included in this study. The majority of the study participants, 56.4% (44/78) were male and were in the age group of 40–60 years. The majority, 57.7% (45/78) participants, were unaware that DR could affect their vision. The prevalence of proliferative DR and clinically significant macular edema was 3.8% (3/78 each). Conclusion: Our study suggests an increased prevalence of DR in the study population, which seems to be a concern.
背景:糖尿病最具破坏性的后果之一是糖尿病视网膜病变(DR),这种疾病对个人、卫生保健系统和全球经济造成重大的财政和卫生保健负担。本研究旨在估计查谟地区(查谟和克什米尔)三级医院住院糖尿病患者中DR的患病率。方法:本横断面研究纳入查谟政府医学院18岁以上的1型或2型糖尿病患者,既往医师诊断或血红蛋白A1C≥6.5% (48 mmol/mol),符合参与条件。排除标准包括过去5年内诊断的1型糖尿病。此外,还收集了视网膜病变继发危险因素的数据,如病程、糖化血红蛋白和相关合并症。结果:78例已知诊断为糖尿病的患者被纳入本研究。大多数研究参与者,56.4%(44/78)是男性,年龄在40-60岁之间。大多数,57.7%(45/78)的参与者没有意识到DR会影响他们的视力。增生性DR和临床显著性黄斑水肿患病率分别为3.8%(3/78)。结论:我们的研究表明,DR在研究人群中的患病率增加,这似乎是一个值得关注的问题。
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引用次数: 0
Chemotherapy-induced acute reversible toxic leukoencephalopathy 化疗引起的急性可逆性中毒性脑白质病
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_24_22
A. Vishnu, T. Pratap, D. Jacob, M. Jalal, Anupama Gopalakrishnabhakthan
Acute toxic leukoencephalopathy can be due to a variety of endogenous and exogenous agents. Chemotherapy-induced toxic leukoencephalopathy is often encountered in clinical practice with the widespread use of various chemotherapeutic agents. Since initial clinical findings may be nonspecific, magnetic resonance imaging can be useful in the pattern recognition of white matter injury as well as to rule out its close differentials. Early diagnosis is important since prompt removal of the inciting agent and supportive therapy can reverse this condition, while delay can result in a poor prognosis. Here, we report a case of chemotherapy-induced toxic leukoencephalopathy in a patient with metastatic adenocarcinoma of the rectum from an imaging perspective.
急性中毒性白质脑病可由多种内源性和外源性因素引起。随着各种化疗药物的广泛使用,化疗引起的中毒性脑白质病在临床实践中经常遇到。由于最初的临床表现可能是非特异性的,磁共振成像可以用于白质损伤的模式识别以及排除其密切的差异。早期诊断很重要,因为及时去除刺激剂和支持治疗可以逆转这种情况,而延迟可能导致预后不良。在这里,我们从影像学的角度报告一例化疗诱导的中毒性脑白质病患者转移性直肠腺癌。
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引用次数: 1
Management of symptomatic posterior circulation flow aneurysms associated with agenesis of the internal carotid artery 伴有颈内动脉发育不全的症状性后循环动脉瘤的治疗
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_114_21
A. Padmanabhan, V. Moses, Munawwar Ahmed, Krishna Prabhu, Bijesh Nair, B. Joseph, S. Keshava
Internal carotid artery agenesis, unilateral or bilateral is a rare congenital anomaly. Cerebral circulation challenged by this lack of anterior supply is compensated by increased flow through the posterior circulation and circle of Willis. This hyperdynamic circulation results in flow-related aneurysms, especially along the branching segments. We present the clinical, imaging and endovascular management of three symptomatic patients with discussion of relevant literature.
单侧或双侧颈内动脉发育不全是一种罕见的先天性异常。脑循环由于前侧供血不足而受到挑战,可通过后循环和威利斯循环增加血流来补偿。这种高动力循环导致血流相关动脉瘤,特别是沿着分支段。我们报告三例有症状患者的临床、影像学和血管内治疗,并对相关文献进行讨论。
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引用次数: 0
Clinicoetiological profile of acute ischemic stroke patients in the therapeutic window in a tertiary care hospital in Northern India 急性缺血性脑卒中患者在印度北部三级医院治疗窗口的临床病因学概况
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_20_22
A. Chandra, Maqbool Wani, A. Raina, Hilal Ganie, W. Dar, Arjimand Yaqoob, Ravouf Asimi
Background: A stroke is defined by the rapid emergence of clinical symptoms and focuses on evidence (applicable to individuals in a deep coma and those with subarachnoid hemorrhage) or widespread brain damage. The study aimed to evaluate the clinical characteristics of patients with acute ischemic stroke in a tertiary care hospital in North India. Methods: By analyzing case files and conducting patient interviews, information on the patients was gathered and evaluated. The study's inclusion and exclusion criteria were based on the 2018 American Heart Association and American Stroke Association (AHA/ASA) thrombolysis guidelines for acute ischemic stroke. Recent major trauma or major surgery within 14 days not involving the head, seizure at the onset of stroke, systemic malignancy, and pregnancy were excluded. Results: The study enlisted the participation of 76 patients who were divided into two groups. Patients in the one group were given tenecteplase, whereas the other group were given alteplase. Patients in the tenecteplase and alteplase groups were of different ages and had various other risk factors for hypertension, atrial fibrillation, diabetes, smoking, and previous stroke or transient ischemic attack. The risk factor distribution in both the groups was statistically significant for variables such as hypertension and diastolic blood pressure (P < 0.05). Stroke in internal carotid artery territory was present in 3 out of 42 in the tenecteplase group and 2 out of 32 in the alteplase group. Most patients in both the groups had a stroke of undetermined cause. Small vessel and large vessel strokes were found in 9.5% and 14.7%, respectively. Conclusion: In the development of stroke, there is a definite relationship between age and gender. A sedentary lifestyle, food, and obesity are risk factors for stroke. According to an AHA/ASA drug utilization analysis, most medicines were appropriate for stroke patients.
背景:脑卒中的定义是临床症状的迅速出现,重点关注证据(适用于深度昏迷和蛛网膜下腔出血的个体)或广泛的脑损伤。本研究旨在评估印度北部三级医院急性缺血性脑卒中患者的临床特征。方法:通过对病例资料的分析和对患者的访谈,收集和评价患者的信息。该研究的纳入和排除标准基于2018年美国心脏协会和美国卒中协会(AHA/ASA)急性缺血性卒中溶栓指南。排除近期重大外伤或14天内不涉及头部的大手术、卒中发作时癫痫发作、全身性恶性肿瘤和妊娠。结果:该研究招募了76名患者,他们被分为两组。一组患者给予替奈普酶,另一组患者给予阿替普酶。替奈普酶组和阿替普酶组患者年龄不同,有高血压、房颤、糖尿病、吸烟、既往卒中或短暂性脑缺血发作等危险因素。两组高血压、舒张压等危险因素分布差异有统计学意义(P < 0.05)。42名替普酶组患者中有3名出现颈内动脉卒中,32名替普酶组中有2名出现颈内动脉卒中。两组中的大多数患者都发生了原因不明的中风。小血管和大血管中风分别占9.5%和14.7%。结论:在脑卒中的发展过程中,年龄和性别有一定的关系。久坐不动的生活方式、饮食和肥胖是中风的危险因素。根据AHA/ASA药物使用分析,大多数药物适用于脑卒中患者。
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引用次数: 0
The incidence of trauma with the use of glidescope in anticipated difficult airway cases – A prospective observational study 预期气道困难病例中使用滑翔镜的创伤发生率-一项前瞻性观察研究
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_94_21
M. Jeyakumar, M. Abraham, Georgene Singh, T. Chandy
Background: Glidescope video-laryngoscope (GVL) is an invaluable equipment for patients with anticipated difficult intubations that aids in visualizing the vocal cords out of line-of-sight. However, despite the ease in the visualization and shortening of the time taken to visualise the cords, the intubation time is often prolonged and is associated with trauma. This study aims at identifying incidence of trauma with glidescope in anticipated difficult airway scenario and whether correct practice by experienced anesthesiologist can reduce trauma. Methodology: Eighty-nine adult patients with anticipated difficult airway who were intubated using GVL by experienced anesthesiologists in a tertiary care setting were studied. The time to visualize, the time to intubate, the difficulties encountered at intubation were documented, the incidence of trauma was reported. The factors associated with trauma were analyzed using PSPP software (psppire. exe 0.8.4-g012d99). Results: The incidence of airway trauma was 11.2%. It was higher in the group with technical difficulties (Gtd) (P < 0.001) and was less in the hands of an experienced anesthesiologist (P = 0.02). Conclusion: GVL intubation in anticipated difficult airway cases by experienced anesthesiologists using the right technique has lesser incidence of trauma, lesser than that is seen with Macintosh intubations in anticipated difficult airway scenario. Knowledge on techniques to troubleshoot technical difficulties with GVL may reduce the incidence of trauma further and needs to be studied more.
背景:滑翔镜视频喉镜(GVL)对于预期插管困难的患者是一种宝贵的设备,它有助于在视线外观察声带。然而,尽管很容易观察到声带,缩短了观察声带所需的时间,但插管时间往往会延长,并与创伤有关。本研究旨在确定滑翔镜在预期气道困难情况下的创伤发生率,以及经验丰富的麻醉师的正确操作是否可以减少创伤。方法:89例预期气道困难的成年患者在三级护理机构由经验丰富的麻醉师使用GVL插管。记录观察时间、插管时间、插管时遇到的困难,并报告创伤发生率。应用PSPP软件对创伤相关因素进行分析。exe 0.8.4-g012d99)。结果:气道损伤发生率为11.2%。在技术困难组(Gtd)中,这一比例较高(P < 0.001),而在经验丰富的麻醉师手中,这一比例较低(P = 0.02)。结论:经验丰富的麻醉师使用正确的技术在预期气道困难病例中进行GVL插管比Macintosh插管的创伤发生率低。关于解决GVL技术困难的技术知识可能会进一步减少创伤的发生率,需要更多的研究。
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引用次数: 0
Effect of a hydrogen peroxide gas-plasma sterilization on physical integrity and quality of N95 respirators: An experimental study during the COVID-19 pandemic 双氧水等离子体灭菌对N95口罩物理完整性和质量影响的实验研究
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_9_22
Malathi Murugesan, S. Radha, Bhagteshwar Singh, P. Mathews, Suresh Devasahayam, P. Rupali
Background: N95 respirators have prevented transmission among health-care workers during the COVID-19 pandemic. During times of intense shortage of respirators and border closures during the pandemic, re-use strategies with available decontamination methods were necessitated. This in-house experimental study evaluated the effect of hydrogen peroxide gas-plasma sterilization on respirators and helped establish an evidence-based protocol for their re-use in a resource-poor setting. Materials and Methods: A three-dimensional experimental model using saline nebulization as the aerosol exposure and a particle counter to measure the filtration of particles through the mask pre- and post-sterilization was used. Multiple cycles of plasma sterilization were done till the physical integrity/fit was lost. Total filtration volume was used as a surrogate marker to assess the filtration efficiency (FE). Results: The total volume of particles filtered on a 3M respirator was 99.9%. Unused Halyard and Venus respirators were compared against 3M and found to have FE of 99.9% and 60.5%, respectively. After repeated sterilization cycles, the total volume of particles filtered was 59.3% for Halyard in the seventh cycle and 36.2% for Venus in the fifth cycle. When the physical integrity and fit was tested, the appropriate fit was lost after eight cycles of sterilization for Venus and was not lost for Halyard even after the tenth cycle. Conclusion: This low-cost experimental study helped implement an effective and safe decontamination strategy for safe re-use of N95 respirators in an emergent situation with no access to commercial testing in a resource poor health-care setting during the pandemic.
背景:N95口罩在COVID-19大流行期间阻止了卫生保健工作者之间的传播。在大流行期间呼吸器严重短缺和边境关闭期间,有必要采用具有可用去污方法的重复使用战略。这项内部实验研究评估了过氧化氢气体等离子体灭菌对呼吸器的影响,并帮助建立了在资源匮乏环境下呼吸器再利用的循证方案。材料与方法:采用三维实验模型,以生理盐水雾化为气溶胶暴露,用粒子计数器测量灭菌前后面罩中颗粒的过滤情况。多次进行等离子体灭菌,直到失去物理完整性/契合度。以总过滤体积作为评价过滤效率的替代指标。结果:3M口罩过滤颗粒的总积为99.9%。将未使用的Halyard和Venus呼吸器与3M进行比较,发现其FE分别为99.9%和60.5%。经过多次循环灭菌,Halyard第7次和Venus第5次的颗粒过滤总量分别为59.3%和36.2%。当对身体完整性和契合度进行测试时,维纳斯的合适契合度在8个周期的消毒后就消失了,而哈利亚德的合适契合度在10个周期后也没有消失。结论:这项低成本的实验研究有助于在疫情期间,在资源匮乏的卫生保健环境中,在无法获得商业检测的紧急情况下,实施有效和安全的去污战略,安全重复使用N95口罩。
{"title":"Effect of a hydrogen peroxide gas-plasma sterilization on physical integrity and quality of N95 respirators: An experimental study during the COVID-19 pandemic","authors":"Malathi Murugesan, S. Radha, Bhagteshwar Singh, P. Mathews, Suresh Devasahayam, P. Rupali","doi":"10.4103/cmi.cmi_9_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_9_22","url":null,"abstract":"Background: N95 respirators have prevented transmission among health-care workers during the COVID-19 pandemic. During times of intense shortage of respirators and border closures during the pandemic, re-use strategies with available decontamination methods were necessitated. This in-house experimental study evaluated the effect of hydrogen peroxide gas-plasma sterilization on respirators and helped establish an evidence-based protocol for their re-use in a resource-poor setting. Materials and Methods: A three-dimensional experimental model using saline nebulization as the aerosol exposure and a particle counter to measure the filtration of particles through the mask pre- and post-sterilization was used. Multiple cycles of plasma sterilization were done till the physical integrity/fit was lost. Total filtration volume was used as a surrogate marker to assess the filtration efficiency (FE). Results: The total volume of particles filtered on a 3M respirator was 99.9%. Unused Halyard and Venus respirators were compared against 3M and found to have FE of 99.9% and 60.5%, respectively. After repeated sterilization cycles, the total volume of particles filtered was 59.3% for Halyard in the seventh cycle and 36.2% for Venus in the fifth cycle. When the physical integrity and fit was tested, the appropriate fit was lost after eight cycles of sterilization for Venus and was not lost for Halyard even after the tenth cycle. Conclusion: This low-cost experimental study helped implement an effective and safe decontamination strategy for safe re-use of N95 respirators in an emergent situation with no access to commercial testing in a resource poor health-care setting during the pandemic.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72877796","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
Ensuring training of medical students in bioethics competencies as an integral part of medical curriculum 确保医学生的生物伦理学能力培训作为医学课程的一个组成部分
Pub Date : 2022-07-01 DOI: 10.4103/cmi.cmi_52_22
S. Shrivastava, P. Shrivastava
Ethics has been considered an integral and indispensable part of the health-care profession for multiple decades. The term “bioethics” generally refers to the study of ethical issues arising because of the development made in the field of medicine, biology, and technology, which might become a cause of concern for humans or detrimentally affects the association between human and their environment. In order to streamline the training process of medical students in bioethics, there is an indispensable need to define the competencies that need to be covered during the training period. We must understand that teaching bioethics is way more than covers a theoretical topic, rather it requires exposure of medical students to a number of practical and clinically relevant scenarios. In conclusion, training medical students in bioethics have to be acknowledged as an important need, as it will eventually determine the safety and well-being of the current and future generations of people. It is high time that specific steps are taken to define specific bioethics competencies and integrate them with the existing medical curriculum to benefit both medical students and the general population.
几十年来,道德一直被认为是保健专业不可缺少的组成部分。“生物伦理学”一词一般是指研究由于医学、生物学和技术领域的发展而产生的伦理问题,这些问题可能成为人类关注的原因或对人类与其环境之间的关系产生不利影响。为了简化医学生在生物伦理学方面的培训过程,有必要确定在培训期间需要涵盖的能力。我们必须明白,生物伦理学的教学不仅仅是一个理论主题,而是需要医学生接触一些实际的和临床相关的场景。总之,必须承认对医科学生进行生物伦理学培训是一项重要的需要,因为它最终将决定今世后代的安全和福祉。现在是时候采取具体步骤,确定具体的生物伦理学能力,并将其与现有的医学课程相结合,以使医学生和一般民众都受益。
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引用次数: 1
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Current medical issues
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