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   Table of Contents - Current issue
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July-December 2021
Volume 12 | Issue 2
Page Nos. 59-101

Online since Monday, February 28, 2022

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ORIGINAL ARTICLES  

“Clinical Profile of Neonates with Patent Ductus Arteriosus and Factors Predicting Prolonged Paracetamol Treatment and Outcome” – A retrospective Study p. 59
K Shilpa, BK Praveen, Prem Alva
DOI:10.4103/mjmsr.mjmsr_52_20  
Introduction: Patent ductus arteriosus (PDA) comprises 5%–10% of all congenital heart diseases, excluding premature infants. It is more common in females than in males. Clinical evidence of PDA appears in 45% of neonates with a birth weight of <1750 g and in about 80% of neonates with a birth weight of <1200 g. Significant PDA occurs in 15% of premature infants with a birth weight of <1750 g and in 40%–50% of those with a birth weight of <1500 g. Materials and Methods: The present study was a retrospective, observational, descriptive, record-based study conducted in the department of neonatology of our medical college from March 2015 to April 2020. All the clinical parameters, echo details, and treatment histories were obtained from the patients' case records and were analyzed. Results: In the present study, a total of 56 cases of hemodynamically significant PDA were evaluated. Thirty-seven of them had primary closure, 17 of them had secondary closure, and 2 of them had no closure. Conclusion: From the present study, we conclude that the larger the size of PDA, the longer is the duration for closure. The presence of complications such as pulmonary hemorrhage and prolonged ventilation were associated with delayed closure.
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A study of knowledge, attitude, and practice of Pap smear test in the early detection of cervical cancer among qualified working women in an urban area p. 64
Reethu Vincy, T Umashankar
DOI:10.4103/mjmsr.mjmsr_34_21  
Introduction: Cervical cancer (CC) is being one among the leading causes for cancer-related deaths worldwide contribute to a massive portion of mortality which can be reduced to a great extent with the help of a screening test – Pap smear test; with which early detection and thus prevention of this cancer is made possible. Despite the fact that Pap smear test has proved itself to be an easily available and cost-effective method to screen the early signs of CC among prone women, a large group of women is hesitant to get it done due to various reasons. Hence, this was conducted to study the degree of knowledge, attitude, and practice of Pap smear test among qualified working women in urban areas. Materials and Methods: In this cross-sectional study, 334 working-class women who had an undergraduate/postgraduate qualification and were engaged in different types of occupation were selected. These participants were requested to answer a questionnaire which extracted information about the individual's demographic data; knowledge, attitude, and practice regarding CC, Pap smear test, and Human papillomavirus vaccination. Data so collected were analyzed using the SPSS version 23 software. Results: The participants belonged to the age group of 22–59 years with mean age being 33.4 years. The study population was broadly categorized into two groups as teaching occupation (n = 221; 66.2%) and nonteaching occupation (n = 113; 33.8%). Overall, 45% of the participants knew that CC is the cancer of the lower part of uterus. Forty-five percentage did not know the benefits of Pap smear test. Knowledge sourced from family, friends, and health care professionals was 30% and 6%, respectively. Medical camps contributed to 17% of the knowledge in the overall study group. Forty-nine percentage of the participants did not know Pap smear test has to be done regularly. Overall, only 26 participants (8%) underwent Pap smear test. Most of them were in the age range of 31–40 years and the least were in the age range of 21–30 years. Knowledge and attitude toward Pap smear test are the major indicators and predictors of the utilization and performance of this test. The practice of doing Pap smear test and thus the performance of this test was higher among those who had higher knowledge (Group II P < 0.005) and better attitude toward Pap smear test. Studies reveal that pain, lack of knowledge, insufficient medical recommendations, and health education, time constraints, embarrassment, and fear of bad results are the main barriers in getting Pap smear test done. This brings to light the need to revamp our strategy in health education.
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Association of comprehensive correct HIV/AIDS knowledge among caregivers of children living with HIV and disclosure of HIV status p. 70
Nishanth Krishna Kodyalamoole, Sanjeev B Badiger
DOI:10.4103/mjmsr.mjmsr_40_21  
Context: Knowledge regarding HIV/AIDS results in better self-care and lesser risk behavior. For children living with HIV (CLHIV) since birth, the caregivers need to disclose the HIV status for them to know regarding HIV. Poor knowledge among caregivers is a barrier to the disclosure of HIV status. Aims: The aim is to assess the knowledge among caregivers of CLHIV regarding HIV/AIDS and to evaluate the association between comprehensive correct HIV/AIDS knowledge (CCAK) among caregivers of CLHIV and disclosure of HIV status. Settings and Design: A cross-sectional study was conducted among 91 caregivers of CLHIV in an antiretroviral therapy center in southern coastal Karnataka between October 2014 and July 2015. Subjects and Methods: The data were collected using a structured questionnaire by interview method. Statistical Analysis Used: Frequencies were calculated for the categorical data. For scoring, the correct answers and wrong answer and “Don't know” options were given one mark and zero marks, respectively. Chi-square test was done to check for the association between knowledge and disclosure of the child's HIV status. Results: The knowledge regarding HIV/AIDS was good in 90% of the cases and moderate in the remaining 10%. However, the CCAK was present in only around 40% of the caregivers. The lowest knowledge was regarding the benefits of condom in preventing transmission of HIV. There was no association between CCAK and disclosure of HIV status to the CLHIV in the present study. Conclusions: Although the overall knowledge regarding HIV/AIDS was good among caregivers, they lacked CCAK. There was no association between CCAK and disclosure of the HIV status to the child.
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Association of menstrual pattern with lifestyle factors among female medical students p. 75
Garima Namdev, Sabiha Naz
DOI:10.4103/mjmsr.mjmsr_33_21  
Introduction: Menstrual disorders are more frequently observed among young females, especially medical students nowadays. Various lifestyle factors such as frequent consumption of fast foods, dietary habits, physical exercise, and yoga practicing play a very great role in alteration of menstruation pattern. All of these variables are affected by weight gain which is determined by body mass index (BMI), which itself affect menstrual pattern. Aims and Objectives: The aim of this study was to determine the association of menstrual pattern with lifestyle factors and BMI among medical students. Materials and Methods: A cross-sectional observational study was done among sixty undergraduate female medical students with the help of pretested and predesigned questionnaire consisting of menstrual pattern, premenstrual syndrome (PMS), and dysmenorrhea along with details about lifestyle factors. Anthropometric measurements such as weight, height, and BMI were also taken. Chi-square test was applied to test the association between menstrual pattern and lifestyle factors. Results: Out of total, 60% of students had regular cycle, 63% had dysmenorrhea, and 75% possess PMS. Majority of obese (65.2%) students had irregular cycle and 52.1% suffered from dysmenorrhea. Maximum 91% and 77.4% of students had regular cycle practicing yoga and physical exercise, respectively, whereas 86.2% of students suffered from PMS among those not exercising regularly. All of these findings were found statistically significant. Conclusion: More than half of students possess regular cycle. Overweight and obesity were found to be associated with irregular menstrual cycle and dysmenorrhea. Lifestyle factors such as yoga practicing, frequent consumption of fast foods, and regular physical exercise affect menstrual pattern in the present study.
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Comparative study of conventional Ziehl−Neelsen and bleach concentration method in detecting acid-fast bacilli in fine-needle aspiration material of lymph nodes p. 80
Parnajeet Mandal, Soma Ghosh, Abhijit Banerjee, Uma Banerjee
DOI:10.4103/mjmsr.mjmsr_32_21  
Background: Tuberculosis (TB), specific infectious disease, affects most of the organs of the human body. Extrapulmonary TB manifests commonly as lymphadenopathy. Emergence of acquired immunodeficiency syndrome warrants the rapid diagnosis to limit its spread. Aim and Objectives: The application of bleach concentration method in detecting tubercle bacilli in the material obtained by fine-needle aspiration (FNA) of lymph nodes, evaluating sensitivity of bleach concentration method over conventional direct smear method in diagnosing tubercular lymphadenitis, detecting bacilli in the background of granuloma formation. Materials and Methods: The prospective, hospital-based, cross-sectional study was carried out in a study population of 78 patients where 15 cases got eliminated following the cytological diagnosis of malignancy and inadequacy of sample. Patients with lymphadenopathy underwent FNA after clinical examination, history taking, and informed consent. The aspirated material was stained with Leishman, H and E, conventional Ziehl−Neelsen (ZN), and bleach concentration method. Data were collected and statistical analysis done. Results: The predominant age group affected was (16–30) years with male preponderance. 44.44% cases were cytomorphologically diagnosed with tuberculous lymphadenitis. Acid-fast Bacilli (AFB) was found in 23 cases by conventional ZN method and 39 cases by bleach concentration method. Sensitivity of bleach method was 92.35% compared to 54.76% in conventional ZN method. Bacilli positivity was more in cases presenting with necrosis than with granuloma alone. Conclusion: Bleach method for detecting AFB is more sensitive than conventional ZN method. It is safe, inexpensive, easy to perform, requires no additional equipment, and safe to handle in laboratory.
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Mucocutaneous side effects of gefitinib p. 86
Ruhaila Thekkath, Chellappan Nonam, Rani Mathew, Beena Sunny
DOI:10.4103/mjmsr.mjmsr_48_21  
Background: Epidermal growth factor receptor (EGFR) is a transmembrane glycoprotein which is expressed in various tissues. Aberrant EGFR signaling plays an important role in carcinogenesis. Gefitinib, an EGFR inhibitor, is a promising drug in treatment of various malignancies. Awareness about the various mucocutaneous side effects of gefitinib will help in optimum management. Hence, we decided to conduct this study. Materials and Methods: We did a descriptive study and observed the various cutaneous side effects in 40 patients who were treated with gefitinib in a tertiary care center in South Kerala. Results: Dermatological adverse reactions were observed in 87.5% of our patients, the most common being dryness and pruritus in 67.5% and 65% of patients, respectively. Rashes were of Grade 1/2 severity in most of our cases. Conclusions: Cutaneous reactions, though common, were mild in majority of our patients. Studies with more sample size and follow-up are needed to improve our knowledge.
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Awareness of forensic odontology among general dental practitioners in Mumbai: A survey study p. 90
Rishabh G Mistry, Treville Pereira, Subraj Shetty, Swati Gotmare, AK Anjali, Rutuja Vidhale
DOI:10.4103/mjmsr.mjmsr_3_21  
Introduction: Forensic odontology is the application of dental knowledge in human identification. It has major implications in criminal investigation, and human remains identification. Objective: The aim of this study is to introspect the attitude and knowledge of forensic odontology among general dental practitioners (GDPs) in Mumbai. Materials and Methods: A cross-sectional study was conducted in a sample size of 225 GDPs of Mumbai with the help of an online questionnaire comprising 11 questions. Results: GDPs were found to have a lack of exposure and poor knowledge regarding the subject of forensic odontology. Only 13.3% of dentists have had a formal training in the subject. About 29.3% are unaware that they can testify in the court and support the investigation. Conclusion: The lack of awareness and knowledge among dentists will hinder the criminal investigation. Hence, awareness should be created among young dentists and more courses should be available in the field.
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SHORT COMMUNICATIONS Top

Inclusion of podcasts as a tool in the delivery of medical education p. 95
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/mjmsr.mjmsr_10_21  
The scope of information technology is on the rise in the field of health care and has started to have a significant impact on the delivery of medical education considering the changing needs of the medical students. Podcasts have been linked with multiple merits as it gives an opportunity for the teacher to enhance their teaching beyond classroom settings in terms of time and place option. As the students can learn as per their convenience, it augments self-directed, lifelong learning, and gives a chance to medical students to refine their knowledge outside college hours. It is always good to record podcasts on those topics which are of practical and clinical significance to the medical students. In conclusion, podcast in medical education is a useful inclusion for enhancing learning among medical students respecting the principles of adult learning. The need of the hour is to have an appropriate match of both conventional teaching–learning methodologies and podcasts, and the overall process of learning can be enhanced by adding a component of assessment.
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Exposing medical students to Pecha Kucha during their training period: Need of the hour p. 97
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/mjmsr.mjmsr_45_20  
A medical doctor in the current generation is bound to get exposed to a wide range of scenarios, wherein they are expected to share their thoughts, ideas, expertise in a convincing and appealing way to the public. In order to improve the attention of the audience, we have to resort to something which is innovative, creative, yet concise and appealing. Pecha Kucha is a method of presentation which is designed to maintain interest of the audience, especially during the course of a series of presentations. However, we have to accept that only adoption of the Pecha Kucha format won't do wonders unless it is supplemented with good communication skills, positive body language and modulation of tone. In conclusion, the format of Pecha Kucha is a learner-centered approach with an aim to improve the attention span of the audience and ensure that the presentation is not being extended beyond time limits. In-fact, it has to be considered as an approach to improve the speaker abilities with regard to abstraction, analysis, and synthesis.
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Educational research by medical teachers: A neglected yet an important domain p. 99
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/mjmsr.mjmsr_46_20  
The process of medical education in general is a complex and demanding one, which can significantly improve upon based on the findings of research activities. Educational research is a formal and systematic approach to get deeper insights of the educational process, and with an aim to study and resolve educational problems, thereby improving the overall efficiency of the medical training. The generated evidence is crucial to bring about curricular reforms and significantly plays an important role in the development of a professional. In conclusion, promotion of educational research should be looked upon as the way to ensure better health professions education and to improve the accountability of the medical colleges towards the needs of the community. In-fact, educational research is the approach to gain valuable insights into the complexities of medical teaching and assessment and improve the overall process through timely curricular reforms.
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LETTER TO EDITOR Top

Reference values of dorsal sural sensory nerve action potential: A useful tool to diagnose peripheral neuropathy p. 101
Mahmood Dhahir Al-Mendalawi
DOI:10.4103/mjmsr.mjmsr_37_21  
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