Background& Objective:Abdominal compartment syndrome is as potentially lethal condition caused by any event that produces intra-abdominal hypertension. The most common cause is blunt abdominal trauma. Increasing intra-abdominal pressure affects much vital body system. Hemodynamic, respiratory, renal and neurological abnormalities are hallmark of ACS. All authors are agreeing that decompression laparotomy is the treatment of choice for the ACS. Nursing care involves vigilant monitoring for early detection including serial measurement of intra-abdominal pressure (from urinary bladder). This study was designed to investigate the comparative effect of measurement of intra-abdominal pressure and physical exam in patient with ACS for refer the patients to operation room. Methodology:In this research ACS was defined as abdominal distention with intra-abdominal pressure ≥15 mm Hg (20cm H2O) accompanied by at least two of the following: oliguria or anuria, hypoxemia and hypotension or shock. When ACS detected by researcher, compared with diagnose of need to laparotomy by physician both timely and numerically.Results:Of 100 patients admitted over 8 months, 28 patients had abdominal compartment syndrome, 21 of this patients refer to operation room by physician. According to numeral comparison between two group not significant (P>.05) but according the time measuring abdominal pressure for detection of need to decompressed laparotomy significantly decreased than physical exam (p<.05).Conclusion:The ACS is a potentially lethal condition occurs in a significant number of severely blunt abdominal trauma patients and it develops quickly. Preventative therapy should be instituted to minimize its development in patients at risk and monitoring of intraabdominal pressure may allow prompt treatment of this condition rather than physical exam.
Introduction: There is substantial evidence on the usefulness of meditation for the reduction of blood pressure and stress. Regular practice of meditation improves cardiovascular and mental health. There are lots of documented evidences that meditation is effective in coronary artery diseases. Aims: The study was done to ascertain immediate effect of meditation on blood pressure profile in young healthy students. Methodology: Our study was done in 84 healthy students of 17-20 years of age group of Pramukhswami Medical College, Karamsad. In study group (n=42), students were asked to sit in quiet room and meditation was done for 10 minutes. In this group, blood pressure and heart rate were taken before the meditation and after the meditation. In control group (n=42), blood pressure and heart rate were taken initially then they were allowed to sit comfortably in quiet room for 10 minutes, after that again blood pressure and heart rate were taken. Results: In comparison to control group, in study group SBP, PP and MAP were significantly reduced after meditation from 116.38±14.10 to 109.88±10.55 (P
: Background and Objectives: Problem-based learning (PBL) is an innovative educational approach in which the students determine what they need to learn. The present study was done to review the pros and cons of PBL, with the aim to introduce reforms in the traditional teaching methodology.Methods: A total of 200 MBBS students participated in the study. Six PBL exercises were allotted to the students and after their completion, they were asked to fill the questionnaire regarding their perceptions about PBL on a 5-point Likert scale, as well as open ended questions to elicit two reasons each for liking and disliking PBL.Results: Regarding the students’ perceptions, the mean/median scores of all the items was found to be ≥ 3, indicating the positive inclination of students towards PBL. The major favourable factors of PBL were the opportunity of group discussion (16%) and better understanding (15.8%). The major drawbacks in PBL were that preparation required more time (20.5%), inadequate discussion (12.8%) and large group size(11.0%) Interpretation and Conclusion: Students generally favour PBL, as it enhances their ability to handle and solve real-life problems; however, few of the challenges are also accompanied with it which should be looked into to improvise it. [Manisha J NJIRM 2016; 7(4):78-81]
Background & Objective: Anatomy is one of the fundamental subjects taught to the medical students in their first year of medical curriculum. Of its many subdivisions, gross anatomy is one of the vast and important components covered in a short span of one year. The content matter of this subject is very volatile and many undergraduate students face difficulty in learning and recapitulating it. There are many methods adopted by students for learning Anatomy and flashcards is one amongst it. This study was thus planned with an objective to design flashcards for learning gross anatomy, to administer it to the undergraduates for self study revision and to take their perceptions on it. Methodology: The flashcards for gross anatomy of upper limb and lower limb were designed and given to the first year undergraduate students of a premier Medical College in Mumbai. The perceptions of the students on the use of flashcards in learning Anatomy were taken on a prevalidated questionnaire and analyzed. Results: 90% of the students felt that the flashcards helped them to do a quick revision, memorize the content easily and thus perform better in the exams. Conclusion: Flashcards proved to be an effective self study tool for learning gross anatomy [Patil R NJIRM 2016; 7(2):110-112]
Objective: The aim of this narrative review is to examine the available literature related to central sensitization (CS) and altered central pain processing in chronic low back pain (CLBP) patients. Methodology: Literature was searched using many electronic databases. Additionally, reference list of most prominent articles were searched to increase the search accuracy, as much as possible. Studies which are evaluating the concept of CS in conservatively treated CLBP patients were included. Results: Results of studies evaluating the responsiveness to various types of stimuli in CLBP patients are contradictory. Some studies in CLBP patients have showed increased pain responses after sensory stimulation of body parts outside the painful region, when some other studies report no differences between patients and healthy controls. Studies evaluating the integrity of the endogenous pain inhibitory systems describe unchanged activity of this descending inhibitory system. Conversely, studies examining brain structure and function in connection with experimentally induced pain provide initial proof for changed central pain processing in CLBP patients. Also inappropriate beliefs about pain, depression and/or pain catastrophizing, may lead to the development of CS. Conclusion: Most of the literatures suggest that the CNS becomes centrally sensitized in a subgroup of patients with CLBP. However, the significance of this involvement is just starting to become clearer. This could be an active topic of future research. More studies are necessary for providing definite evidence for the clinical importance of CS. [Bid D NJIRM 2016; 7(3):114 - 123]
Background & objectives: Knowledge of the gingival zenith (GZ) of the maxillary anterior teeth can be clinically applied to re-establish the proper gingival contour of the maxillary anterior teeth during esthetic anterior oral rehabilitation and smile designing. The purpose of this study was to evaluate gingival zenith (GZ) of each individual maxillary anterior tooth and their relative gingival zenith level. Method: A digital caliper was used to measure the gingival zenith of the maxillary anterior teeth from left canine to right canine on casts made from 30 young individuals without any dental deformity. The highest point on gingival margin of all maxillary anterior teeth was marked. Distance of this gingival zenith from the respective vertical bisector of each tooth was calculated. Also, the digital caliper was used to measure the distance of gingival zenith of the lateral incisors from a line connecting gingival zenith of maxillary central incisor and canine. Results: Significant difference exists between the gingival zenith of maxillary central incisors, lateral incisors and canines. Conclusion: Gingival zenith of maxillary incisors is distally placed whereas for canine it coincides with vertical bisector. Gingival zenith of lateral incisor is incisal to that of central incisor and canine. [Hitendra S NJIRM 2016; 7(4): 113-116]
Periodontal diseases are common chronic inflammatory diseases caused by pathogenic microorganisms which induce elevations of pro-inflammatory cytokines resulting in tissue destruction. Evolution of periodontal diseases is influenced by many local or systemic risk factors.Stress a term continually being re-defined in the scientific study of disease and illness,is nevertheless a confirmed and important factor in the etiology and maintenance of many inflammatory diseases, including periodontal disease. Stress is not what happens to us, it is our response to what happens and response is something we can choose. Stress results in delayed healing of the connective tissues and bone, apical migration of thejunctional epithelium and formation of periodontal pocket.Stress may negatively influence the outcome of periodontal treatment. In this review we will discuss the role of stress that might be playing in periodontal disease is considered. [Dr.Anita P NJIRM 2016; 7(4): 147-153]
Background & objectives: Empathy and Emotional Intelligence are the two affective domain parameters which significantly affect a doctor’s way of treating patients; hence they may influence the doctor-patient relationship. Establishing a proper doctor-patient relationship has a great impact on professional success of the doctor. Thus, the present study was aimed to assess whether there is any association between empathy of dental practitioners towards their patients and the dental practitioners’ emotional intelligence. Methods: A cross-sectional study was conducted on a sample of 243 dental practitioners including clinicians, academicians and post-graduate students from Bareilly city who were instructed to complete a self-administered questionnaire. The questionnaire consisted of the Health Professional (HP) version of the Jefferson Scale of Physician Empathy (JSPE) and the Schutte’s Emotional Intelligence Scale (SEIS). Pearson’s correlation coefficient and linear regression were used to test the statistical significance of the observations. Results: A positive correlation was found between empathy and emotional intelligence. The correlation was significant p=0.05, even after adjusting for the confounders and the regression model showed significance with r value of 0.12 Interpretation & Conclusion: Empathetic dentists were found to have higher emotional intelligence. Irrespective of variations in age, gender, qualification, occupation and years of working experience, empathy and emotional intelligence showed positive correlation. [Gupta A NJIRM 2016; 7(4):106-112]
Objective: Internet addiction is characterized by excessive or poorly controlled preoccupations, urges or behaviours regarding computer use and Internet access that lead to impairment or distress in individual’s psychological state. This study was aimed to assess the frequency of internet addiction and its possible association with anxiety severity and quality of life among medical students. Methods: This was an observational, cross sectional, single-centred, self-assessable questionnaire based study administrated among 525 consenting medical students. The participants were assessed by proforma containing demographic details,variables related with internet use, questionnaires of IAT (Internet Addiction Test for Internet Use), BAI (Beck’s Anxiety Inventory) and WHOQOL-BREF (World health organization quality of life assessment scale). Statistical data were analysed by Graph Pad InStat version 3.06 using Chi–square test and Mann-Whitney test. Results: Frequency of problematic users among medical students was 9.3 % with frequency of internet addiction 0.9%.Participants with problematic internet use were likely to experience high severity of anxiety (p
Background & Objective: Many undergraduate medical students prefer to concentrate on clinical subjects and tend to neglect paraclinical subjects like Microbiology. A time has come when motivation is mandatory for the current generation of students. The present study attempts to introduce quiz as an innovative learning method. A quiz is a quick way of gathering information on how well our students are meeting their learning objectives. The present study is aimed to assess the students’ knowledge and interest in Microbiology subject. Methodology: The present study was conducted in the department of Microbiology, D.Y. Patil medical college, Kolhapur, on second MBBS students. Five teams were enrolled from the neighboring medical colleges. We assessed the students’ knowledge by giving pre and post MCQ tests followed by various rounds of quiz competition. Results: There was a significant increase in students’ knowledge in post MCQ test than that of pre MCQ test (P< 0.0001). It was also observed that all the students had developed interest in Microbiology subject. Conclusion: We observed from the present study that even a simple intervention like quiz can make a significant improvement in the knowledge of medical students and help them to develop interest in microbiology subject. [Chougale R NJIRM 2016; 7(3): 101 - 106]
Background and objective:Nurses provide the first-hand bedside care to the patients in a hospital thus have a direct role in hospital infection control. Thus to improve hygiene behaviour of staff, training sessions on hospital infection control is necessary. The objective of this study was to assess the impact of training on knowledge and practices regarding hospital infection control amongst nursing staff working in tertiary care centre. Method: The study included 89 nurses from different wards and I.C.U. A pre-test and a post-test was conducted with a set of 20 self designed multiple choice questions in three days session of training covering important aspects of hospital infection control. Improvement in pre-test and post test for individual candidate was assessed and statistical data analysis was done. Results: Response rate of the questionnare was 100%.The mean pre-test score was 9(S.D 3.06) while mean post-test score was 14(S.D 6.34). The difference in pre-test and post-test was statistically significant(P< 0.00001) taking 95% confidence interval. Interpretation and conclusion: Training sessions and workshops for healthcare workers conducted regularly will help curbing nosocomial infections and providing a better patient care. [Jyoti C NJIRM 2016; 7(4):39-43]
Introduction: Pulmonary nocardiosis is a well-described infection in patients with neoplastic disease, human immunodeficiency virus (HIV) infection. The radiographic appearance of pulmonary nocardiosis is varied and nonspecific. Since the clinical and radiologic manifestations are non-specific, and the microbiological diagnosis is often difficult. In some patients, pulmonary nocardiosis will be mistaken for other infections, such as tuberculosis or bacterial pneumonia. Hence this study was undertaken to detect the prevalence of nocardiasis in HIV infected patients. Material and Methods: One hundred chest symptomatic patients screened for HIV infection and the samples of HIV positive patient processed for Nocardia using kinyoun�s modification of zeihl Neelsen stain and culture. The CD4 count of HIV patients with Nocardial infection and co-infection by mycobacterium tuberculosis studied. Observations: Out of 100 patients with cough and fever more than 2 weeks, 58 turned out to be HIV positive. Most of the patients included in the study were in their 3rd and 4th decades of life. The male to female ratio was 1:0.38. The open tuberculosis cases were 43.45% and sputum positive for acid fast bacilli. The nocardiosis was observed in 3.45% cases by modified Kinyoun�s method of staining and culture. In 80.65% tuberculosis cases, CD4 count less than 200/μl, while 19.35% had CD4 count more than 200/μl. The cases with nocardiosis had CD4 count less than 200/μl. Co-infection with tuberculosis and nocardiosis is not observed. The history of family contact for tuberculosis was found in 9.68% cases. Conclusion: The prevalence of nocardia in HIV positive individuals for north Maharashtra region is observed. The nocardia are easy to treat if diagnosed correctly and this will help in preventing morbidity in chest symptomatic patients. Unnecessary treatment with higher antibiotics can be avoided and cost effective treatment will be possible. Patients with CD4+ count less than 200 cells/μl should be screened for Nocardia. [Ravindra K NJIRM 2016; 7(5):73-77]
Objective.The present study was designed to define and evaluate examination stress among ,adolescents in the age group of 12–18 years in relation to heart rate variability (HRV), an index of sympathovagal interplay, one of the sensitive neurophysiological axes to be influenced initially, when an individual is exposed to any stressor.Methods. Hari’s stress inventory for students was used to qualify examination stress was collected on 69 healthy school students, free from any acute or chronic ailment, one month and seven days before the start of final examinations along with acquisition of short – term HRV to profile the sympathovagal interplay, a sensitive index of both physical and mental stress. Results. The stress inventory depicted that the sample population was under an enhanced mental stress 7 days before the examination as compared to that observed 1 month before the ratios of HRV 1month and 7 days before the final examination. Significant appreciable difference could also be appreciated in the values of SDANN in time domain and amplitude of the waveforms in HF, LF on the frequency domain of HRV.Conclusion. An enhanced sympathetic outflow as discerned through increase in LF/HF ratio and LF power with a concomitant decrease in HF power along with significant decrease in SDANN values profiling a decreased vagal outflow of the student population denotes an autonomic neurophysiological status that needs a specialist attention in terms of proper and adequate guidance and counselling. [Bagri D NJIRM 2016; 7(4):1-7]
Background: To ascertain the bacteriological profile of patients with nosocomial pneumonia in endotracheal cultures and correlation with blood cultures. Methodology: 559 endotracheal aspirates were collected using mucous traps from 180 patients of suspected nosocomial pneumonia patients over 2 years. The samples were processed and a colony count of 104cfu/ml was taken as the cut-off to differentiate between pathogens and colonizers. Identification and sensitivity of bacterial isolates was done with the help of Vitek 2. Blood for culture was processed as per standard techniques. Results & Conclusion: Klebsiella sp.(33%) was the commonest bacteria isolated, followed by Acinetobacter baumanii, Pseudomonas sp., Escherichia coli and Staphylococcus aureus. 25% of Acinetobacter spp. and 40% of Pseudomonas spp were pandrug resistant. Mostly non-fermenters were sensitive to Tigecycline and Colistin. Enterobacteriaceae showed highest resistance for Cephalosporins and Cotrimoxazole but were mostly sensitive to Tigecycline. Staphylococcus aureus was uniformly sensitive to Linezolid and Teicoplanin. Blood cultures were positive in 52(9.3%) patients of which pulmonary origin bacteremia was present in 33 patients while non-pulmonary origin bacteremia was present in 19 patients. The pulmonary care bundle along with rational use of antibiotics will go a long way to improve treatment outcome, patient morbidity and mortality. [Tiwari U NJIRM 2016; 7(3):60 - 63]
Background: Stress in medical students is increasing nowadays & leading to untoward incidences. It is necessary to identify the stress levels & its causes at earliest so that early interventional measures can be adopted. This study aimed to find out prevalence of stress in medical students & to compare level of stress in males and females. Methodology: Total 338 medical students were evaluated for the presence of stress and its levels (mild/moderate/severe) using the Kessler Psychological Distress Scale (K10).Gender difference for stress levels was compared using student’s ‘t’ test. Reasons for stress were evaluated by a questionnaire. Results: The total prevalence of stress was 57.9% and the prevalence of severe stress was 10.6%. It was found that level of stress was significantly higher (p
Background & Objective: Chronic obstructive pulmonary disease (COPD) is the most common cause of secondary pulmonary hypertension (PH). PH secondary to COPD is associated with a worse prognosis of the disease, a low quality of life, as well as with a higher exacerbation frequency, and consequently with an increase in the healthcare cost of COPD patients. Objective is to assess the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic findings and severity of COPD, if there is any Methodology: A total 100 of patients of COPD were selected and staged by pulmonary function test (PFT) and evaluated by echocardiography. Results: On echocardiographic evaluation of COPD, 55% cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR) was observed in 24/35 cases (67.5%). Pulmonary hypertension (PH), which is defined as systolic pulmonary arterial pressure (sPAP)> 30 mmHg was observed in 15/25 (63%) cases in which prevalence of mild, moderate, and severe PH were 10/17 (58.82%), 3/16 (23.53%), and 3/17 (17.65%), respectively. The frequencies of PH in mild, moderate, severe, and very severe COPD were 16.67%, 54.55%, 60.00%, and 83.33%, respectively. Right atrial pressure was 10 mmHg in 82.5% cases and 15 mmHg in 17.5% cases. Cor pulmonale was observed in 7/17 (41.17%) cases; 7.50% cases had left ventricle (LV) systolic dysfunction and 47.5% cases had evidence of LV diastolic dysfunction defined as A ≥ E (peak mitral flow velocity of the early rapid filling wave (E), peak velocity of the late filling wave caused by atrial contraction (A) on mitral valve tracing) Left ventricle hypertrophy was found in 22.5% cases. Conclusion: Prevalence of PH has a linear relationship with severity of COPD and severe PH is almost associated with cor pulmonale. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions. [Gupta R NJIRM 2016; 7(1):26-30]
Background & Objective: The high prevalence of HIV, HBV, HCV and syphilis has heightened the problems of blood safety in India. TTIs cause fatal, chronic and life-threatening disorders because of their prolonged viraemia and carrier or latent state. Serologic tests utilized routinely in the screening of blood donors, totally not guarantee the absence of these infections among blood donors. Methodology: Samples of HIV, HBsAg, HCV were tested by ELISA and samples of syphilis were tested by RPR method following manufacturer’s instructions. Results: Prevalence of HBV was highest within at the age groups 26-35 years, HCV within the age group between 36-45years, syphilis within the age group between 46-55 years and HIV between 26-35 years. The prevalence of hepatitis B and syphilis was higher among males as compared to females, while for hepatitis C and HIV, it was higher among females as compared to males. Conclusion: Availability of safe blood for transfusion can be achieved by vigorous screening of donors and donated blood. Screening of blood is now mandatory for many diseases and is undertaken routinely in blood banks. The prevalence of TTIs among the Indian blood donors is reported to be ranging as follows; HBV – 0.66% to 12%, HCV – 0.5% to 1.5%, HIV– 0.084% to 3.87%, and syphilis – 0.85% to 3% respectively. Hence strict selection of blood donors with stringent screening and safe methods of detection can minimise risk if TTI. [Shah M NJIRM 2016; 7(1):12-15]
Background & Objective: Type 2 Diabetes mellitus(DM) is a chronic disease. It isone of the important causes of increasing morbidity and mortality in India, which is now known as ‘Capital of Diabetes’. It affects all the major systems in the body bringing down the quality of life of the patient. Objective is to assess the Three - minute walk distance in patients and to compare it with the age and gender matched healthy controls. Methodology: A cross- sectional tertiary care Government hospital based study was conducted in forty diagnosed patients of type 2 DM taking oral hypoglycemics, aged between 40-60 years. All the patients were thoroughly interviewed by a well structured questionnaire, which included personal details as well as the history of complications. 3- Minute walk test was conducted, as per the standardized technique in diabetic patients as well as age and gender matched healthy controls. The distance was compared by applying unpaired t test. Results: The mean 3-minute walk distance in patients of type 2 DM was 139.55±54.90 meters as compared to controls which was 200.01± 45.40 meters. The decrease in distance was statistically highly significant (p
Background & Objective: NMDA is a receptor for the excitatory neurotransmitter glutamate, which is released with noxious peripheral stimuli. The activation of NMDA receptors has been associated with hyperalgesia, neuropathic pain, and reduced functionality of opioid receptors. Hyperalgesia and neuropathic pain are a result of increased spinal neuron sensitization, leading to a heightened level of pain. The reduced function of opioid receptors is caused by a decrease in the opioid receptor's sensitivity. Therefore, NMDA antagonists have a role in these areas of pain management. Ketamine is a strong NMDA antagonist. To study the role of NMDA receptors in pain and modulation by blocking the receptors through antagonist ketamine given pre-emptively and postoperatively via epidural route in patients of lower limb amputation. Methodology: This study was conducted at Civil Hospital Ahmedabad during the year 2012-2015 with the permission of ethical committee of hospital and after written informed consent of 60 adult patients of age group 18- 60 years of either sex and ASA grade 1 or 2 posted for lower limb amputation. Patients were divided into three groups where one was administered epidural opioid and ketamine, the second group was administered epidural opioid only and in the third group epidural saline was administered. Pain scores of all the groups were compared. Results: Requirement of first dose of analgesia in group 1 is after 12.5±1.03hrs, in group 2 after7.6± 0.98 hrs and in group3 after 3.4± 0.8hrs and average duration between consecutive analgesic doses were 11.5hrs in group 1, 7.6hrs in group 2 and 4.5hrs in group 3 respectively. Conclusion: NMDA receptor antagonist is effective in management of acute post-operative pain compared to opioid analgesics alone as the time to first dose of analgesia is much larger in group 1 than 2 and 3. Ketamine has definitive role in opioid sparing effect as supplemental analgesic requirement is decreased. [Lamoria M NJIRM 2015; 7(1):1-6]
