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   2016| May-June  | Volume 29 | Issue 3  
    Online since October 24, 2016

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Cavitatory tuberculosis in complex cyanotic heart disease
Parth Gada, Ira Shah
May-June 2016, 29(3):181-181
Full text not available  [PDF]  [PubMed]
  235 9,285 -
Prevalence and determinants of depression among elderly persons in a rural community from northern India
Priyamadhaba Behera, Pratap Sharan, Ashwani Kumar Mishra, Baridalyne Nongkynrih, Shashi Kant, Sanjeev Kumar Gupta
May-June 2016, 29(3):129-135
Background. Globally, more than 350 million people of all ages suffer from depression. Elderly persons are more vulnerable to depression. We conducted this study to estimate the prevalence of depression, and to study the association of depression with sociodemographic and clinical variables among elderly persons in a rural community. Methods. We conducted a community-based cross-sectional study among 395 randomly selected elderly persons aged 60 years and above in a rural area of Ballabgarh, Haryana, India. The participants were screened by using the Geriatric Depression Scale, and diagnosis was confirmed by the Mini International Neuropsychiatric Interview. Multivariate analysis was done for independent predictors of depression. Results. The prevalence of depression was 11.4% (95% CI 8.6%-14.9%). Living in a nuclear family (adjusted odds ratio [AOR] 8.98, 95% CI 3.40-23.71), lack of physical activity (AOR 4.95, 95% CI 2.00-12.27), whole-time involvement in household work (AOR 4.47, 95% CI 1.18-16.93), presence of two or more chronic diseases (AOR 4.45, 95% CI 1.60-12.35), having no role in family decision-making (AOR 2.77, 95% CI 1.19-6.42), sleep problems in past one year (AOR 2.97, 95% CI 1.32-6.69) and bilateral hearing impairment (AOR 4.00, 95% CI 1.80-8.88) were factors associated with depression in elderly persons. Conclusions. Depression is common among elderly persons in rural areas. Individuals providing healthcare to elderly persons need to be trained to identify depression and take appropriate action; elderly persons with chronic diseases and hearing impairment deserve special attention.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,308 900 -
Use of speech-to-text technology for documentation by healthcare providers
Sima Ajami
May-June 2016, 29(3):148-152
Medical records are a critical component of a patient's treatment. However, documentation of patient-related information is considered a secondary activity in the provision of healthcare services, often leading to incomplete medical records and patient data of low quality. Advances in information technology (IT) in the health system and registration of information in electronic health records (EHR) using speechto- text conversion software have facilitated service delivery. This narrative review is a literature search with the help of libraries, books, conference proceedings, databases of Science Direct, PubMed, Proquest, Springer, SID (Scientific Information Database), and search engines such as Yahoo, and Google. I used the following keywords and their combinations: speech recognition, automatic report documentation, voice to text software, healthcare, information, and voice recognition. Due to lack of knowledge of other languages, I searched all texts in English or Persian with no time limits. Of a total of 70, only 42 articles were selected. Speech-to-text conversion technology offers opportunities to improve the documentation process of medical records, reduce cost and time of recording information, enhance the quality of documentation, improve the quality of services provided to patients, and support healthcare providers in legal matters. Healthcare providers should recognize the impact of this technology on service delivery.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,227 911 -
Geographic eponyms: A history of geography in medicine
Maharra Hussain, Sanjay A Pai
May-June 2016, 29(3):166-168
Geographic eponyms have commonly been used in medical terminology, with diseases and medical entities being named after the place where the condition was discovered (e.g. Bombay Blood group) or invented (Jaipur Foot) or where the disease was first detected (Rocky Mountain Spotted fever) or where a consensus meeting has been held (Banff) or for other reasons (Argentina flag, Congo red stain). In 2015, the WHO decided to adopt a politically correct method to name infectious diseases in the future. We illustrate, in verse form, some of the places that have been used in medical terminology, over the centuries. An accompanying essay explains the specific reasons for the selection of these locales in our vocabulary.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,073 808 -
Inflammatory leg nodules: A clinical and investigational study
Sujay Khandpur, K Maharaja
May-June 2016, 29(3):141-145
Background. Inflammatory leg nodules are a diagnostically challenging group of dermatoses with limited tools for diagnosis. Considerable overlapping patterns exist despite their distinct clinical and histological features. We attempted to understand if undertaking investigations and studying the clinical course and treatment response can help in differentiating these dermatoses. Methods. Forty-three patients presenting with inflammatory leg nodules underwent a series of investigations apart from histopathology. The patients were treated as per the final histological diagnosis and observed for response to treatment and followed up to evaluate the clinical course. Results. There was considerable overlap in the investigations done among various dermatoses. These included elevated erythrocyte sedimentation rate (ESR), Mantoux test and antistreptolysin- O (ASLO) titres in the majority of patients while a few had abnormal findings on chest X-ray, CT scan of the chest and doppler ultrasonography of the legs. About 86% of patients with erythema nodosum, 50% with erythema induratum, 57% with cutaneous medium vessel vasculitis and 93% with unclassified panniculitis responded to non-steroidal non-inflammatory drugs (NSAIDs) alone or had spontaneously resolved with only post-inflammatory hyperpigmentation. Other patients required specific treatment with immunosuppressive or immunomodulatory agents. Conclusions. There is considerable overlap in dermatoses manifesting as inflammatory leg nodules on investigations, treatment received and response to treatment. To categorize them better into distinct entities, this group of dermatoses may require long-term follow-up of the clinical course and response to treatment, repeated investigations especially histopathology during different phases of evolution and progression of disease.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,148 583 -
Pre-transplantation serum ferritin as a prognostic marker in allogeneic haemopoietic stem cell transplant patients in a tertiary care hospital in Malaysia
Subashini C Thambiah, Elizabeth George, Intan Nureslyna Samsudin, Lee Hoong Hong, Ling Ling Chuo, Nabilah Ramli, Muhd Zanapiah Zakaria
May-June 2016, 29(3):136-140
Background. The principal cause of iron overload in patients with haematological malignancies is recurrent red cell transfusions for anaemia. The serum ferritin level reflects the iron burden in the body, in the absence of inflammation or liver disease. In Malaysia, data are lacking on the association between pre-transplant serum ferritin levels and outcome after allogeneic haemopoietic stem cell transplant. Methods. We did a cross-sectional study using retrospective data of 106 post-allogeneic haemopoietic stem cell transplant patients (HLA-matched sibling) with haematological malignancies at Hospital Ampang to determine the relationship between pre-transplant serum ferritin levels and post-transplant outcome, post-transplant complications and survival time. Patients were divided into two groups according to the iron status: serum ferritin level >1000 μg/L (iron overload) and <1000 μg/L. Results. The median age for patients was 30.5 (18-58) years. The median pre-transplantation serum ferritin level and the prevalence of pre-transplantation iron overload were 2423 (408.2-7664) μg/L and 87.5%, respectively. No significant association was found between iron status and demographic factors, type of haematological malignancy and post-transplant complications. Although insignificant, patients with iron overload had a shorter survival time (36 months) compared to those with no iron overload (40 months). There was also no significant association between the iron status and post-transplant outcome. Significant post-transplant complications associated with post-transplant outcome were the need for total parenteral nutrition (TPN) (p=0.014) and chronic graft-versus-host disease (GVHD) (p=0.008). Similarly, significant associations were found between age group (p=0.003), TPN (p=0.035) and chronic GVHD (p=0.012) with survival time using Kaplan-Meir analysis. However, after Cox regression, only age group was found to be significantly associated with survival time (p=0.014). Conclusion. Serum ferritin is an acute phase reactant and its levels increase in the presence of tissue necrosis and inflammation. Both these events occur in haematological malignancies. Although serum ferritin level is a non-invasive, relatively cost-effective, widely available and practical indicator of iron status, it is not specific to iron overload. Therefore, a true association between the serum ferritin level and iron burden is problematic in patients with haematological malignancies.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,174 408 -
Ostium secundum atrial septal defect endocarditis caused by brucella infection
Feridoun Sabzi, Reza Faraji
May-June 2016, 29(3):146-147
The most common cardiovascular presentation of brucellosis (a zoonotic infection) in Iran is aortic valve endocarditis. Brucellosis is a systemic infection and may involve any congenital heart defect with various clinical signs and symptoms. We report brucella endocarditis in an atrial septal defect (ASD) in a 55-year-old man who presented with fever and hemiplegia. Echocardiography showed a secundum ASD with large vegetations of 0.5Χ1 cm arising from the rim of the ASD. Serological analysis was positive for Brucella agglutinin, thus confirming the diagnosis. The brain CT scan revealed a large ischaemic zone in the left hemisphere. At surgery, large vegetations were excised and the defect was closed with fresh pericardium. After surgery the patient was treated with a 4- week course of antibiotics. His recovery was uneventful except for the neurological deficit (hemiplegia); he was discharged on postoperative day 35.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,116 419 -
Standard setting of objective structured practical examination by modified Angoff method: A pilot study
M Ganesh Kamath, Vinod Pallath, K Ramnarayan, Asha Kamath, Sharmila Torke, James Gonsalves
May-June 2016, 29(3):160-162
Background. The undergraduate curriculum at our institution is divided system-wise into four blocks, each block ending with theory and objective structured practical examination (OSPE). The OSPE in Physiology consists of 12 stations, and a conventional minimum score to qualify is 50%. We aimed to incorporate standard setting using the modified Angoff method in OSPE to differentiate the competent from the non-competent student and to explore the possibility of introducing standard setting in Physiology OSPE at our institution. Methods. Experts rated the OSPE using the modified Angoff method to obtain the standard set cut-off in two of the four blocks. We assessed the OSPE marks of 110 first year medical students. Chi-square test was used to compare the number of students who scored less than standard set cut-off and conventional cut-off; correlation coefficient was used to assess the relation between OSPE and theory marks in both blocks. Feedback was obtained from the experts. Results. The standard set was 62% and 67% for blocks II and III, respectively. The use of standard set cut-off resulted in 16.3% (n=18) and 22.7% (n=25) students being declared unsuccessful in blocks II and III, respectively. Comparison between the number, who scored less than standard set and conventional cut-off was statistically significant (p=0.001). The correlation coefficient was 0.65 (p=0.003) and 0.52 (p<0.001) in blocks II and III, respectively. The experts welcomed the idea of standard setting. Conclusion. Standard setting helped in differentiating the competent from the non-competent student, indicating that standard setting enhances the quality of OSPE as an assessment tool.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,089 300 -
'Living in the clouds of a vain illusion': The decline and fall of clinical autopsies
Sanjay A Pai, Sunil K Pandya
May-June 2016, 29(3):125-128
Full text not available  [PDF]  [PubMed]
  1,081 307 -
Assessment of health-related activities of non-governmental organizations in Rajasthan, India
Jaddu Jyothirmai Reddy, Ashish Sharma, Nagesh Bhat, Suraj Multani, Rahul Patel, Sopan Singh
May-June 2016, 29(3):163-165
Public-private partnerships are being encouraged as a part of the comprehensive development framework. We assessed the work profiles of registered non-governmental organizations (NGO) working on health-related activities in Udaipur district, Rajasthan, India by conducting a 16-item pretested questionnaire study. The questions related to various facets of their activities, their scope and process of evaluation. Of the 66 NGOs selected, most (28 [42%]) were working among the general population and had a partnership with a public entity (43 [65.1%]). The running capital of most NGOs (27 [41%]) was `100 000-2 000 000. Only 25 (38%) had a monitoring system to evaluate their progress. There are immense opportunities for NGOs in the health sector in Udaipur. The need of the hour is to encourage various public and private institutions to work together to achieve excellence in healthcare and service delivery.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,079 225 -
Adenocarcinoma cervix with umbilical metastasis
P Damodara Kumaran, DN Sharma, C Jayanthi, Umesh Velu, Sunesh Kumar
May-June 2016, 29(3):174-175
Full text not available  [PDF]  [PubMed]
  915 308 -
Re-entry NEET (National Eligibility-cum-Entrance Test): Opportunity and concerns
Avinash Supe, Tejinder Singh
May-June 2016, 29(3):158-159
Full text not available  [PDF]  [PubMed]
  965 231 -
Curing more colorectal cancer
Mohandas K Mallath, Tanuj Chawla
May-June 2016, 29(3):155-157
Full text not available  [PDF]  [PubMed]
  1,004 183 -
Intensive lowering of blood pressure in acute intracerebral haemorrhage: Where do we stand today?
MV Padma Srivastava
May-June 2016, 29(3):153-154
Full text not available  [PDF]  [PubMed]
  960 210 -
Letter from Ganiyari
Mamta Bhushan Singh
May-June 2016, 29(3):171-172
Full text not available  [PDF]  [PubMed]
  914 254 -
Letter from Mumbai
Sunil Pandya
May-June 2016, 29(3):172-173
Full text not available  [PDF]  [PubMed]
  912 249 -
Learning styles
Tejinder Singh
May-June 2016, 29(3):181-182
Full text not available  [PDF]  [PubMed]
  311 823 -
Ranjit Roy Chaudhury
Sita Naik
May-June 2016, 29(3):169-169
Full text not available  [PDF]  [PubMed]
  928 134 -
Book Reviews

May-June 2016, 29(3):176-179
Full text not available  [PDF]
  890 132 -
Krishan Kumar Malhotra
Indar K Dhawan
May-June 2016, 29(3):170-170
Full text not available  [PDF]  [PubMed]
  893 123 -
News from here and there

May-June 2016, 29(3):185-186
Full text not available  [PDF]  [PubMed]
  290 143 -
Medical education technology workshop for residents: A step towards development of new faculty
Habib Md Reazaul Karim, Md Yunus, A Mishra
May-June 2016, 29(3):180-181
Full text not available  [PDF]  [PubMed]
  228 177 -
Self-harm attempts with corrosive 'acid' among patients referred to psychiatric emergency services: Observations and implications
Raman Deep Pattanayak, Saurabh Kumar, SK Khandelwal
May-June 2016, 29(3):182-183
Full text not available  [PDF]  [PubMed]
  195 156 -
Responses to the Letter from Ganiyari: I
T Sudhakar Bhat
May-June 2016, 29(3):183-183
Full text not available  [PDF]  [PubMed]
  163 140 -
Vivek Arya
May-June 2016, 29(3):187-187
Full text not available  [PDF]  [PubMed]
  173 130 -
Responses to the Letter from Ganiyari: II
R Srivatsan
May-June 2016, 29(3):183-184
Full text not available  [PDF]  [PubMed]
  162 105 -