Background and Aim: Two-point discrimination (TPD) is a useful test for assessing cutaneous sensation. Sensory testing devices for testing TPD values have shown to be valid and reliable in the measurement of the functional sensitivity of the hand and its relativity to touch perception. Evaluation of TPD in the lower extremities is debatable because of dearth of information available in the literature about normative values. The aim of this study is to identify the normative values of TPD of lower limb dermatomes in young, healthy individuals and analyze its relationship with body mass index (BMI) and gender. Materials and Methods: A total of 150 participants of the age group 18–25 undergoing graduation program were included in this study. They underwent TPD test for lower limb (L1 to S2) dermatomes, using a baseline esthesiometer. The Spearman’s ratio test was used to find the relationship between BMI and TPD values. The Mann–Whitney U-test was used to compare TPD values according to gender. Results: The normative value ranged from 1.46 ± 1.27 to 2.61 ± 1.45 in lower limb dermatomes. The minimum value noted was at the S1 dermatome (left) and the maximum at the L2 dermatome (left). In the sidewise analysis of TPD, the median values of both sides were approximately the same. There was a definite correlation (P < 0.05) between female gender and TPD; however, there was no significant correlation between BMI and TPD. Conclusion: This study suggested that women are more perceptive in appreciating TPD values than men. Moreover, TPD values do not vary according to BMI or right and left sides.
{"title":"Normative values of two-point discrimination for lower limb dermatomes in healthy young adults and its correlation with gender and body mass index","authors":"Sanjiv Kumar, Ankita Shetty, Apoorva Nale, ChristinaMary George, Neha Yadav","doi":"10.4103/amhs.amhs_65_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_65_23","url":null,"abstract":"Background and Aim: Two-point discrimination (TPD) is a useful test for assessing cutaneous sensation. Sensory testing devices for testing TPD values have shown to be valid and reliable in the measurement of the functional sensitivity of the hand and its relativity to touch perception. Evaluation of TPD in the lower extremities is debatable because of dearth of information available in the literature about normative values. The aim of this study is to identify the normative values of TPD of lower limb dermatomes in young, healthy individuals and analyze its relationship with body mass index (BMI) and gender. Materials and Methods: A total of 150 participants of the age group 18–25 undergoing graduation program were included in this study. They underwent TPD test for lower limb (L1 to S2) dermatomes, using a baseline esthesiometer. The Spearman’s ratio test was used to find the relationship between BMI and TPD values. The Mann–Whitney U-test was used to compare TPD values according to gender. Results: The normative value ranged from 1.46 ± 1.27 to 2.61 ± 1.45 in lower limb dermatomes. The minimum value noted was at the S1 dermatome (left) and the maximum at the L2 dermatome (left). In the sidewise analysis of TPD, the median values of both sides were approximately the same. There was a definite correlation (P < 0.05) between female gender and TPD; however, there was no significant correlation between BMI and TPD. Conclusion: This study suggested that women are more perceptive in appreciating TPD values than men. Moreover, TPD values do not vary according to BMI or right and left sides.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008396","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_199_22
Y. Motiaa, Youssef Dwassy
COVID-19 has been associated with a spectrum of hematological complications secondary to excessive activation of the immune system. In this article, we report the case of a 64-year-old patient who developed delayed autoimmune hemolytic anemia following a mild severe acute respiratory syndrome-coronavirus-2 infection. We will discuss its pathophysiological, clinical, and biological aspects as well as the clinical management of this complication.
{"title":"Autoimmune hemolytic anemia complicating a non-severe SARS-COV2 pneumonia","authors":"Y. Motiaa, Youssef Dwassy","doi":"10.4103/amhs.amhs_199_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_199_22","url":null,"abstract":"COVID-19 has been associated with a spectrum of hematological complications secondary to excessive activation of the immune system. In this article, we report the case of a 64-year-old patient who developed delayed autoimmune hemolytic anemia following a mild severe acute respiratory syndrome-coronavirus-2 infection. We will discuss its pathophysiological, clinical, and biological aspects as well as the clinical management of this complication.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"45520631","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_162_22
Mallika S. Shetty, Hasan Sarfaraz, K. Shenoy
Background and Aim: Assessing patient satisfaction with dental prosthesis is usually difficult if the prosthesis does not fulfill the treatment need of the patient, and in most cases, the professionals' assessment of the prosthesis differs from the patients' perception of quality and treatment outcome. Patient satisfaction is important for the proper utilization of the prosthesis which helps improve the patients' overall quality of life and that remains the professionals' ultimate goal. The aim of this study was to assess the quality and utilization of dental prostheses and their impact on patient satisfaction. Materials and Methods: A cross-sectional survey was conducted on 1312 participants aged 18 years and above using a house-to-house approach among the rural population of Mangalore taluk. The study involved the completion of a predesigned and structured pro forma based on the WHO oral health assessment form. Evaluation of the prosthesis, and its quality was done by the professional. Fisher's exact test and odds ratio were conducted to find the significance of variables. P < 0.05 was considered statistically significant. Results: It was found that the retention and chewing efficiency of the complete denture had a positive comparison that was statistically significant. The retention of the partial denture wearers had a positive correlation between the patient perception and the professional assessment. In fixed partial dentures candidates, there was a statistically significant comparison between their perception and professionals' assessment with regard to hygiene and periodontal health. Conclusion: Most of the completely edentulous patients residing in the rural population of Mangalore taluk are quite satisfied with their prosthesis, whereas the professional assessment revealed that the older denture lacked retention, occlusion, and hygiene.
{"title":"Assessment of quality and the utilization of the dental prosthesis and their impact on patient satisfaction","authors":"Mallika S. Shetty, Hasan Sarfaraz, K. Shenoy","doi":"10.4103/amhs.amhs_162_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_162_22","url":null,"abstract":"Background and Aim: Assessing patient satisfaction with dental prosthesis is usually difficult if the prosthesis does not fulfill the treatment need of the patient, and in most cases, the professionals' assessment of the prosthesis differs from the patients' perception of quality and treatment outcome. Patient satisfaction is important for the proper utilization of the prosthesis which helps improve the patients' overall quality of life and that remains the professionals' ultimate goal. The aim of this study was to assess the quality and utilization of dental prostheses and their impact on patient satisfaction. Materials and Methods: A cross-sectional survey was conducted on 1312 participants aged 18 years and above using a house-to-house approach among the rural population of Mangalore taluk. The study involved the completion of a predesigned and structured pro forma based on the WHO oral health assessment form. Evaluation of the prosthesis, and its quality was done by the professional. Fisher's exact test and odds ratio were conducted to find the significance of variables. P < 0.05 was considered statistically significant. Results: It was found that the retention and chewing efficiency of the complete denture had a positive comparison that was statistically significant. The retention of the partial denture wearers had a positive correlation between the patient perception and the professional assessment. In fixed partial dentures candidates, there was a statistically significant comparison between their perception and professionals' assessment with regard to hygiene and periodontal health. Conclusion: Most of the completely edentulous patients residing in the rural population of Mangalore taluk are quite satisfied with their prosthesis, whereas the professional assessment revealed that the older denture lacked retention, occlusion, and hygiene.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"43219350","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_175_22
Harjot Singh, D. Dwivedi, U. Tandon, V. Bhatnagar, K. Jinjil, S. Tara
Background and Aim: Palm print and prayer signs are manifestations of “limited joint mobility” syndrome caused by long-standing Type I and Type II diabetes mellitus. This study aims at finding out, which of the two signs is more sensitive for the prediction of difficult intubation in type II diabetes mellitus patients. The secondary objective is to correlate the above two signs with the Cormack–Lehane View during direct laryngoscopy and also to determine whether the duration of Type II diabetes mellitus correlates with difficult intubation in isolation. Materials and Methods: A prospective observational study was carried out in a tertiary care hospital. One hundred and fifty patients suffering from Type II diabetes mellitus, undergoing elective general anesthesia with endotracheal intubation, were enrolled in the study. The correlation between Palm print and Prayer sign with Cormack and Lehane grades was studied using the Chi-square test, continuity correction, and Fisher's exact test. The diagnostic efficacy of intubation difficulty for both the signs was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio. Results: The palm print sign was found to be a better indicator of difficult intubation in type II diabetes mellitus patients (P < 0.01). The duration of Type II diabetes mellitus was found to be associated well with difficult intubation (P = 0.007). Conclusion: Palm print sign is the single most important test for predicting difficult intubation in Type II diabetes mellitus patients. Duration of Type II diabetes mellitus itself correlates well with difficult intubation.
{"title":"Comparing the sensitivity of palm print sign and prayer sign in prediction of difficult intubation in diabetic patients","authors":"Harjot Singh, D. Dwivedi, U. Tandon, V. Bhatnagar, K. Jinjil, S. Tara","doi":"10.4103/amhs.amhs_175_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_175_22","url":null,"abstract":"Background and Aim: Palm print and prayer signs are manifestations of “limited joint mobility” syndrome caused by long-standing Type I and Type II diabetes mellitus. This study aims at finding out, which of the two signs is more sensitive for the prediction of difficult intubation in type II diabetes mellitus patients. The secondary objective is to correlate the above two signs with the Cormack–Lehane View during direct laryngoscopy and also to determine whether the duration of Type II diabetes mellitus correlates with difficult intubation in isolation. Materials and Methods: A prospective observational study was carried out in a tertiary care hospital. One hundred and fifty patients suffering from Type II diabetes mellitus, undergoing elective general anesthesia with endotracheal intubation, were enrolled in the study. The correlation between Palm print and Prayer sign with Cormack and Lehane grades was studied using the Chi-square test, continuity correction, and Fisher's exact test. The diagnostic efficacy of intubation difficulty for both the signs was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio. Results: The palm print sign was found to be a better indicator of difficult intubation in type II diabetes mellitus patients (P < 0.01). The duration of Type II diabetes mellitus was found to be associated well with difficult intubation (P = 0.007). Conclusion: Palm print sign is the single most important test for predicting difficult intubation in Type II diabetes mellitus patients. Duration of Type II diabetes mellitus itself correlates well with difficult intubation.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"48229754","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_246_22
A. Cavanna, G. Purpura, R. Nacinovich
Tic disorders of neurodevelopmental origin are the most common hyperkinetic disorder in childhood. In cases where both multiple motor tics and at least one vocal tic are present, with a chronic course, a diagnosis of Tourette syndrome can be confirmed. Functional movement disorders are a common type of functional neurological disorder, which has previously been referred to as hysteria and conversion, among other diagnostic labels. Functional tics have long been considered a rarer phenotype of functional movement disorder, compared to functional tremor or functional dystonia. However, during the COVID-19 pandemic, there have been multiple reports worldwide of an unexpected increase in the number of adolescents and young adults presenting with acute-onset functional tics. The differential diagnosis between neurodevelopmental and functional tics can be challenging, but a few demographic and clinical features have proven useful in assisting clinicians. Neurodevelopmental tics present with the gradual onset of simple motor and vocal tics in a rostrocaudal evolution, starting in early childhood, more commonly in boys. Conversely, functional tics often have an abrupt and explosive presentation of severe symptoms, with a later age of onset and a female gender predominance. Moreover, it has been reported that a proportion of patients with functional tics developed their symptoms after being exposed to social media content of influencers displaying similar manifestations. The etiology of the recent “pandemic within the pandemic” is likely to be multifactorial, with increased exposure to social media possibly playing a role alongside the psychosocial impact caused by the COVID-19 pandemic.
{"title":"Neurodevelopmental versus functional tics: The state of the art","authors":"A. Cavanna, G. Purpura, R. Nacinovich","doi":"10.4103/amhs.amhs_246_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_246_22","url":null,"abstract":"Tic disorders of neurodevelopmental origin are the most common hyperkinetic disorder in childhood. In cases where both multiple motor tics and at least one vocal tic are present, with a chronic course, a diagnosis of Tourette syndrome can be confirmed. Functional movement disorders are a common type of functional neurological disorder, which has previously been referred to as hysteria and conversion, among other diagnostic labels. Functional tics have long been considered a rarer phenotype of functional movement disorder, compared to functional tremor or functional dystonia. However, during the COVID-19 pandemic, there have been multiple reports worldwide of an unexpected increase in the number of adolescents and young adults presenting with acute-onset functional tics. The differential diagnosis between neurodevelopmental and functional tics can be challenging, but a few demographic and clinical features have proven useful in assisting clinicians. Neurodevelopmental tics present with the gradual onset of simple motor and vocal tics in a rostrocaudal evolution, starting in early childhood, more commonly in boys. Conversely, functional tics often have an abrupt and explosive presentation of severe symptoms, with a later age of onset and a female gender predominance. Moreover, it has been reported that a proportion of patients with functional tics developed their symptoms after being exposed to social media content of influencers displaying similar manifestations. The etiology of the recent “pandemic within the pandemic” is likely to be multifactorial, with increased exposure to social media possibly playing a role alongside the psychosocial impact caused by the COVID-19 pandemic.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"47467132","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_202_22
Shaveta Kataria, E. Rajni, Priyanka Thandi, Mohit Kumar, Garima Kulhari
Background and Aim: Ventilator-associated pneumonia (VAP) is considered as a sub-category of healthcare-associated infections and is associated with high morbidity and mortality. Acinetobacter baumannii complex and Klebsiella pneumoniae (K. pneumoniae) are known to be the most important causes. During the last few decades, polymyxins have represented the most commonly used antimicrobial options against multidrug resistant K. pneumoniae. However, in some cases, aminoglycosides were also found to be effective. Materials and Methods: This retrospective observational study was conducted in a tertiary care hospital in Jaipur from June' 2020 to June' 2021. All endotracheal (ET) aspirate samples from the clinically suspected cases of VAP received in microbiology laboratory were processed using the standard procedures and relevant medical records were reviewed. VITEK 2 automated system was used for the bacterial identification and antimicrobial susceptibility testing. Results: Out of 705 ET aspirate samples received during the study period, 467 were found culture positive. Majority 304 (98.1%) were Gram-negative isolates, while only 6 (1.9%) were Gram-positive. 156;51.3% isolates belonged to A. baumannii complex, followed by K. pneumoniae (73;24.0%). Antimicrobial susceptibility profile of 73 K. pneumoniae isolates to aminoglycosides was noted. Out of 73 isolates, 42 were found to be resistant to both gentamicin and amikacin, 12 isolates were sensitive to both, while 19 isolates showed variable susceptibility. Conclusion: K. pneumoniae is an important causative agent of VAP. While polymyxins have an important role in the management of such cases, aminoglycosides need to be given a careful consideration. They can constitute an effective polymyxin sparing regimen, especially for carbapenem-resistant isolates.
{"title":"Role of aminoglycosides in management of ventilator-associated pneumonia caused by Klebsiella pneumoniae: A report from a tertiary care hospital in Jaipur","authors":"Shaveta Kataria, E. Rajni, Priyanka Thandi, Mohit Kumar, Garima Kulhari","doi":"10.4103/amhs.amhs_202_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_202_22","url":null,"abstract":"Background and Aim: Ventilator-associated pneumonia (VAP) is considered as a sub-category of healthcare-associated infections and is associated with high morbidity and mortality. Acinetobacter baumannii complex and Klebsiella pneumoniae (K. pneumoniae) are known to be the most important causes. During the last few decades, polymyxins have represented the most commonly used antimicrobial options against multidrug resistant K. pneumoniae. However, in some cases, aminoglycosides were also found to be effective. Materials and Methods: This retrospective observational study was conducted in a tertiary care hospital in Jaipur from June' 2020 to June' 2021. All endotracheal (ET) aspirate samples from the clinically suspected cases of VAP received in microbiology laboratory were processed using the standard procedures and relevant medical records were reviewed. VITEK 2 automated system was used for the bacterial identification and antimicrobial susceptibility testing. Results: Out of 705 ET aspirate samples received during the study period, 467 were found culture positive. Majority 304 (98.1%) were Gram-negative isolates, while only 6 (1.9%) were Gram-positive. 156;51.3% isolates belonged to A. baumannii complex, followed by K. pneumoniae (73;24.0%). Antimicrobial susceptibility profile of 73 K. pneumoniae isolates to aminoglycosides was noted. Out of 73 isolates, 42 were found to be resistant to both gentamicin and amikacin, 12 isolates were sensitive to both, while 19 isolates showed variable susceptibility. Conclusion: K. pneumoniae is an important causative agent of VAP. While polymyxins have an important role in the management of such cases, aminoglycosides need to be given a careful consideration. They can constitute an effective polymyxin sparing regimen, especially for carbapenem-resistant isolates.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"42630427","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_272_22
T. Chacko
Leadership literature indicates that focus has shifted from “top-down hierarchical” to “leadership everywhere” approach within organizations and this also applies to academic leadership. The context in which the new eco-leadership discourse has emerged, is presented as it is important for academic leaders to be aware that they need to tailor their leadership style and approach to be ready for the 21st century challenges arising from “triple disruptions due to digital and technology revolution, environmental emergency, and rising societal iniquity.” The framework of “leading from within” that has emerged from research on leadership in higher education has been found to be relevant and resonates well with academic leaders in India and so is presented in greater detail. Understanding of different academic leadership frameworks has been used to generate guidelines for academic leaders to use for implementing the changes that they would be expected to make to improve quality and make faculty future-ready.
{"title":"Academic leadership in the era of curricular and quality transition toward excellence: Frameworks that guide actions needed for facilitating and sustaining change","authors":"T. Chacko","doi":"10.4103/amhs.amhs_272_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_272_22","url":null,"abstract":"Leadership literature indicates that focus has shifted from “top-down hierarchical” to “leadership everywhere” approach within organizations and this also applies to academic leadership. The context in which the new eco-leadership discourse has emerged, is presented as it is important for academic leaders to be aware that they need to tailor their leadership style and approach to be ready for the 21st century challenges arising from “triple disruptions due to digital and technology revolution, environmental emergency, and rising societal iniquity.” The framework of “leading from within” that has emerged from research on leadership in higher education has been found to be relevant and resonates well with academic leaders in India and so is presented in greater detail. Understanding of different academic leadership frameworks has been used to generate guidelines for academic leaders to use for implementing the changes that they would be expected to make to improve quality and make faculty future-ready.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"48204231","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_147_22
Banothu Sudhakar, Vura Jyothi, V. Sowmya, P. Kumar, Suneel Bhookya, K. Surender, T. Chandra
Background and Aim: Psychological and biochemical factors are responsible for the behavioral problems in children with epilepsy. A study was conducted to find the prevalence of behavioral problems in children with epilepsy and also to identify the relation among socioeconomic status, age of onset of seizure, and frequency of seizure attacks with the prevalence of behavioral problems. Materials and Methods: It was a prospective observational study conducted in the Department of Pediatrics, Kakatiya Medical College, Warangal. Convenient sampling was considered; the study was conducted for 2 years. Children aged 1–12 years, admitted with epilepsy to pediatric intensive care unit and pediatric wards, were included in this study. Those were having intellectual problems, cerebral palsy, developmental delay, and metabolic and neurodegenerative disorder were excluded from the study. Sociodemographic information was collected from the parents in a standard pro forma. Diagnostic and Statistical Manual of Mental Disorders-oriented scales for different ages were used for the assessment of behavior by translating into regional language. Chi-square test was used; P < 0.05 was considered statistically significant. Results: A total of 112 children were included; male: female ratio was 1.39; 41 (36.6%) children had behavioral problems; age-wise, there was significant difference; gender-wise, there was no significant difference. Attention-deficit/hyperactivity problems were identified to be the predominant. Statistically, there was no significant difference between behavioral problems either with mother education or with parent's socioeconomic status, respectively. When brain imaging was done, normal studies were revealed in 32% of children with behavior problem. Conclusion: Each and every child with epilepsy aged <5 years and frequency of seizure attack >1 time/year needs thorough screening for behavioral problems irrespective of gender and family characteristics.
{"title":"An observational study on behavioral problems among the children with epilepsy","authors":"Banothu Sudhakar, Vura Jyothi, V. Sowmya, P. Kumar, Suneel Bhookya, K. Surender, T. Chandra","doi":"10.4103/amhs.amhs_147_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_147_22","url":null,"abstract":"Background and Aim: Psychological and biochemical factors are responsible for the behavioral problems in children with epilepsy. A study was conducted to find the prevalence of behavioral problems in children with epilepsy and also to identify the relation among socioeconomic status, age of onset of seizure, and frequency of seizure attacks with the prevalence of behavioral problems. Materials and Methods: It was a prospective observational study conducted in the Department of Pediatrics, Kakatiya Medical College, Warangal. Convenient sampling was considered; the study was conducted for 2 years. Children aged 1–12 years, admitted with epilepsy to pediatric intensive care unit and pediatric wards, were included in this study. Those were having intellectual problems, cerebral palsy, developmental delay, and metabolic and neurodegenerative disorder were excluded from the study. Sociodemographic information was collected from the parents in a standard pro forma. Diagnostic and Statistical Manual of Mental Disorders-oriented scales for different ages were used for the assessment of behavior by translating into regional language. Chi-square test was used; P < 0.05 was considered statistically significant. Results: A total of 112 children were included; male: female ratio was 1.39; 41 (36.6%) children had behavioral problems; age-wise, there was significant difference; gender-wise, there was no significant difference. Attention-deficit/hyperactivity problems were identified to be the predominant. Statistically, there was no significant difference between behavioral problems either with mother education or with parent's socioeconomic status, respectively. When brain imaging was done, normal studies were revealed in 32% of children with behavior problem. Conclusion: Each and every child with epilepsy aged <5 years and frequency of seizure attack >1 time/year needs thorough screening for behavioral problems irrespective of gender and family characteristics.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"46735703","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_121_22
Shouvik Das, A. Chaudhuri, B. Ray
Background and Aim: The COVID-19 pandemic has imposed huge challenges on medical students and medical educators as they are the frontline workers in health-care management. The present study was conducted to evaluate and compare depression, anxiety, and stress levels and the Impact of Event Scale scores among different phases of undergraduate medical students. Materials and Methods: The present study was conducted online at Burdwan Medical College after taking institutional ethical clearance and informed consent from participants. The Depression, Anxiety, and Stress Scale-21 (DASS-21) scores and the Impact of Event Scale-Revised (IES-R) scores of all phases of MBBS students were evaluated during the first and second waves of the pandemic. Jamovi software was used for statistical analysis and ANOVA was used to compare different groups. Results: There was no significant difference in the DASS-21 scores among all five groups during the first wave, but significant differences were observed in IES-R scores. On post hoc analysis, significant differences were observed in the Intrusion, Avoidance, and Hyperarousal scores between 1st- and 5th-year, 2nd- and 5th-year, and 4th- and 5th-year students. During the second wave, significant differences in DASS-21 and IES-R parameters were observed between the different phases of MBBS students. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant negative correlation between IES-R scores and anxiety scores among 2nd-year students during the first evaluation. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant positive correlation between IES-R scores and stress scores among 5th-year students during the second evaluation. Conclusion: Senior batches of MBBS students were more mentally affected by the impact of the pandemic as evaluated by DASS-21 scores and IES-R scores. Levels of depression, stress, and anxiety were also increased during the second wave as compared to the first wave of the present pandemic.
{"title":"A study to evaluate the impact of COVID-19 on the mental health of medical students","authors":"Shouvik Das, A. Chaudhuri, B. Ray","doi":"10.4103/amhs.amhs_121_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_121_22","url":null,"abstract":"Background and Aim: The COVID-19 pandemic has imposed huge challenges on medical students and medical educators as they are the frontline workers in health-care management. The present study was conducted to evaluate and compare depression, anxiety, and stress levels and the Impact of Event Scale scores among different phases of undergraduate medical students. Materials and Methods: The present study was conducted online at Burdwan Medical College after taking institutional ethical clearance and informed consent from participants. The Depression, Anxiety, and Stress Scale-21 (DASS-21) scores and the Impact of Event Scale-Revised (IES-R) scores of all phases of MBBS students were evaluated during the first and second waves of the pandemic. Jamovi software was used for statistical analysis and ANOVA was used to compare different groups. Results: There was no significant difference in the DASS-21 scores among all five groups during the first wave, but significant differences were observed in IES-R scores. On post hoc analysis, significant differences were observed in the Intrusion, Avoidance, and Hyperarousal scores between 1st- and 5th-year, 2nd- and 5th-year, and 4th- and 5th-year students. During the second wave, significant differences in DASS-21 and IES-R parameters were observed between the different phases of MBBS students. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant negative correlation between IES-R scores and anxiety scores among 2nd-year students during the first evaluation. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant positive correlation between IES-R scores and stress scores among 5th-year students during the second evaluation. Conclusion: Senior batches of MBBS students were more mentally affected by the impact of the pandemic as evaluated by DASS-21 scores and IES-R scores. Levels of depression, stress, and anxiety were also increased during the second wave as compared to the first wave of the present pandemic.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"43627962","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}
Pub Date : 2022-07-01DOI: 10.4103/amhs.amhs_263_22
G. Menon, S. Srinivasan, R. Nair, Ajay Hegde, S. Nair
Intramedullary spinal cord tumors constitute an uncommon group of central nervous system neoplasms which pose considerable diagnostic and management challenges. Often low grade, these tumors have an insidious onset and slow progression, which makes early diagnosis a challenge. Advances in magnetic resonance imaging technology have greatly aided the diagnosis and preoperative planning of intramedullary tumors. Yet, radiological diagnosis can be difficult in the presence of several tumor mimics. The introduction and advancement of microsurgical techniques have made surgery the preferred treatment modality. Timing of intervention, however, is contentious. Eloquence of the surrounding tissue and the unforgiving nature of the spinal cord adds to the surgical challenge. Their treatment and prognosis is largely dependent on tumor histology and patient functionality. Well-demarcated tumors like ependymomas and hemangioblastomas can be resected completely with good outcome. Infiltrative tumors such as high-grade astrocytomas are best managed with biopsies or limited resections. Postoperative deficits can be crippling and the use of intraoperative neurophysiologic monitoring and other adjuncts is mandatory. Subtotal resection carry a high risk of recurrence and gross total resection carries a high risk of operative morbidity. With the availability of newer imaging modalities and intraoperative adjuncts, the earlier pessimistic conservative approach has been replaced by an aggressive surgical approach. This review provides an overview on the entire spectra of spinal intramedullary tumors with particular focus on management strategies.
{"title":"Spinal intramedullary tumors","authors":"G. Menon, S. Srinivasan, R. Nair, Ajay Hegde, S. Nair","doi":"10.4103/amhs.amhs_263_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_263_22","url":null,"abstract":"Intramedullary spinal cord tumors constitute an uncommon group of central nervous system neoplasms which pose considerable diagnostic and management challenges. Often low grade, these tumors have an insidious onset and slow progression, which makes early diagnosis a challenge. Advances in magnetic resonance imaging technology have greatly aided the diagnosis and preoperative planning of intramedullary tumors. Yet, radiological diagnosis can be difficult in the presence of several tumor mimics. The introduction and advancement of microsurgical techniques have made surgery the preferred treatment modality. Timing of intervention, however, is contentious. Eloquence of the surrounding tissue and the unforgiving nature of the spinal cord adds to the surgical challenge. Their treatment and prognosis is largely dependent on tumor histology and patient functionality. Well-demarcated tumors like ependymomas and hemangioblastomas can be resected completely with good outcome. Infiltrative tumors such as high-grade astrocytomas are best managed with biopsies or limited resections. Postoperative deficits can be crippling and the use of intraoperative neurophysiologic monitoring and other adjuncts is mandatory. Subtotal resection carry a high risk of recurrence and gross total resection carries a high risk of operative morbidity. With the availability of newer imaging modalities and intraoperative adjuncts, the earlier pessimistic conservative approach has been replaced by an aggressive surgical approach. This review provides an overview on the entire spectra of spinal intramedullary tumors with particular focus on management strategies.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","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":"44157186","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}
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