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  Citation statistics : Table of Contents
   2018| July-August  | Volume 31 | Issue 4  
    Online since May 14, 2019

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Telemedicine and virtual consultation: The Indian perspective
Navneet Ateriya, Ashish Saraf, Vikas Premlal Meshram, Puneet Setia
July-August 2018, 31(4):215-218
DOI:10.4103/0970-258X.258220  PMID:31134926
Telemedicine was considered futuristic and experimental some years ago, but it is a reality today. It is now emerging as an important tool for convenient as well as specialized healthcare, particularly for patients in remote locations with limited access to standardized healthcare services. However, there are multiple challenges to realizing its full potential. We focus on some key medicolegal and ethical issues such as doctor–patient relationship, informed consent, rights of the patient, malpractice, and principles of confidentiality relevant to the practice of telemedicine and virtual consultation. We explore the global as well as the Indian legal perspective pertaining to the application of telemedicine. The absence of specific laws for registration and practice of telemedicine and virtual consul-tation in India acts as a deterrent for medical practitioners to engage in its potential use. Hence, there is a need for specific legislation.
  20 16,636 2,034
Sleep patterns, hygiene and daytime sleepiness among adolescent school-goers in three districts of Tamil Nadu: A descriptive study
Gowtham Murugesan, Logamani Karthigeyan, Praveen Kumar Selvagandhi, Vijayaprasad Gopichandran
July-August 2018, 31(4):196-200
DOI:10.4103/0970-258X.258216  PMID:31134922
Background. Sleep is important for the growth, development and good health of adolescents. We assessed sleep patterns, hygiene and daytime sleepiness among school-going adolescents in 3 districts of Tamil Nadu. Methods. We conducted a cross-sectional survey among 538 school-going adolescents between the ages of 10 and 17 years, from 8 schools in 3 districts of Thiruvallur, Thiruppur and Namakkal selected through multistage sampling. A questionnaire with items focusing on demographic details, sleep patterns, sleep hygiene behaviour and daytime sleepiness was given to the students for self-administration after obtaining informed consent from their parents and school authorities. Results. Over 64% of adolescents sleep <8 hours at night with 5.6% sleeping <6 hours. About 48% of adolescents suffered from prolonged sleep-onset latency and about 43% had interrupted sleep. Over 64% of adolescents watched television (TV) in bed and >23% reported use of mobile phone in bed. About 64% of adolescents had at least one form of poor sleep hygiene behaviour. Decreasing age (0.7; 95% CI 0.582–0.843), studying while lying in bed (1.72; 95% CI 1.009–2.942), greater time gap between dinner and bedtime (0.795; 95% CI 0.650–0.972), staying awake late in the night and chatting on mobile phone (2.24; 95% CI 1.266–3.978) and watching TV (3.41; 95% CI 2.037– 5.722) significantly influenced excessive daytime sleepiness. Conclusion. A large proportion of adolescent students have abnormal sleep patterns and sleep hygiene behaviours. There is a need for concerted sleep-related education at the school level.
  4 3,825 701
Heatstroke: Causes, consequences and clinical guidelines
Yogesh Jain, R Srivatsan, Antony Kollannur, Anand Zachariah
July-August 2018, 31(4):224-227
DOI:10.4103/0970-258X.258224  PMID:31134930
  3 4,477 723
Medical students’ perception of the educational environment in a tertiary care teaching hospital in India
Anandhi Amaranathan, Kadambari Dharanipragada, Subitha Lakshminarayanan
July-August 2018, 31(4):231-236
DOI:10.4103/0970-258X.258226  PMID:31134932
Background. The educational environment perceived by students has an impact on satisfaction with the course of study and academic achievement. We aimed to analyse the perceptions of medical students about their learning environment and to provide feedback to stakeholders involved in curriculum planning and execution. Methods. We did a cross-sectional descriptive study at Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry using the Dundee Ready Educational Environment Measure (DREEM) questionnaire. The DREEM inventory was administered to the undergraduate students of all semesters (n = 452). Students’ perceptions of learning, perception about teachers, academic self-perceptions, perceptions of atmosphere and their social self-perceptions were measured. The scores obtained were expressed as mean (standard deviation) and analysed using t-test and 1-way ANOVA (with post-hoc comparison using Tukey test). The difference between semesters and gender was also analysed. Results. The mean (SD) global score was 122.06 (22.27), out of a maximum possible score of 200. Our students opined that teachers were knowledgeable, with this component scoring the maximum of 3.32 and, at the same time, they felt that teaching overemphasizes factual learning (1.41). Only 6 items scored <2. ‘Students’ perception of atmosphere’ scored high among other domains (30 of 48, 62.5%). The mean global score of preclinical students (125.35 [20.43]) was better than clinical students (119.13 [23.44]; p = 0.003). Conclusion. Although the global score is more positive, we identified a few areas of concern such as overemphasis on factual learning, authoritarian teachers, the not-so-helpful existing learning strategies, vast curriculum (inability to memorize all), lack of supporting system for stressed out students and the boredom they felt in the course. These vital areas should be addressed by the stakeholders for the betterment of learning in the institute.
  3 2,128 282
Elements of a successful hospital-based deceased donation programme in India: Zero to eighty-five in two years
Philip G Thomas, C Aswathy, George Joshy, Jacob Mathew
July-August 2018, 31(4):201-205
DOI:10.4103/0970-258X.258217  PMID:31134923
Background. Legislation has made organ donation after brain death (DBD) possible in India since 1994. However, no organs are donated in most parts of the country; the national organ donation rate is estimated at between 0.08 and 0.34 donors per million population—one of the lowest in the world. Methods. A 350-bedded private hospital in Kochi started its DBD programme in September 2013 with a structured approach based on counselling of family members of critically ill individuals. A counsellor trained to diagnose family dynamics, and recognize different stages of the grieving process, chose the right time, and the correct family member to whom the donation request could be made. Regular debriefing sessions of the core team consisting of a transplant surgeon, a transplant coordinator, an ICU counsellor and a unit administrator resulted in setting up systems that supported families of patients with catastrophic brain injury, and created an environment conducive to obtaining consent. Results. A total of 85 organ donations took place in the first 24 months (September 2013 to September 2015) of instituting the programme. Conclusion. It is possible with hospital-based teamwork and a structured approach to consistently elicit organ donation.
  2 2,184 524
First National Conference on Ethical Healthcare (NCEH) 2018, Alliance of Doctors for Ethical Healthcare (ADEH), All India Institute of Medical Sciences, New Delhi, 21-22 April 2018
Arun Gadre, Shweta Marathe
July-August 2018, 31(4):239-240
DOI:10.4103/0970-258X.258228  PMID:31134934
  1 947 325
Letter from Chennai
MK Mani
July-August 2018, 31(4):242-244
DOI:10.4103/0970-258X.258230  PMID:31134936
  1 936 124
Risk of lower gastrointestinal bleeding with low-dose aspirin: To give or not to give?
Mohammad Ali, Ashish Sharma
July-August 2018, 31(4):219-221
DOI:10.4103/0970-258X.258221  PMID:31134927
  1 1,433 335
A Meeting of the Minds: European and Tamil encounters in modern sciences, 1507-1857.
Anantanarayanan Raman
July-August 2018, 31(4):248-250
  - 963 303
Gamification for nurturing healthy habits
Suptendra Nath Sarbadhikari, Jyotika Maggo Sood
July-August 2018, 31(4):253-254
DOI:10.4103/0970-258X.258236  PMID:31134941
  - 1,968 379
Can one be so wrong about NEET?
Nilakantan Ananthakrishnan
July-August 2018, 31(4):254-254
DOI:10.4103/0970-258X.258237  PMID:31134942
  - 935 207
Hospital awareness rather than public awareness is key to promote organ donation
CE Karunakaran, J Amalorpavanathan
July-August 2018, 31(4):193-195
DOI:10.4103/0970-258X.258215  PMID:31134921
  - 1,934 297
Paraneoplastic palmar fasciitis
Vivek Arya, Mohammad Ali, Ashish Sharma
July-August 2018, 31(4):251-251
DOI:10.4103/0970-258X.258234  PMID:31134939
  - 794 166
Hemispheric cerebral oedema due to intracranial dural arteriovenous fistula
Klaudia Jezowska, Marta Waliszewska-Prosól, Maria Ejma, Pawel Szewczyk
July-August 2018, 31(4):252-252
DOI:10.4103/0970-258X.258235  PMID:31134940
  - 603 115
Letter from Glasgow
Harpreet S Kohli
July-August 2018, 31(4):245-246
DOI:10.4103/0970-258X.258231  PMID:31134937
  - 561 109
Letter from London
Anna Ruddock
July-August 2018, 31(4):247-247
DOI:10.4103/0970-258X.258232  PMID:31134938
  - 606 109
Introducing a molecular basis to physiology in undergraduate medical education
Arpita Mukhopadhyay, D Savitha, Anura V Kurpad
July-August 2018, 31(4):228-230
DOI:10.4103/0970-258X.258225  PMID:31134931
Background. Medical professionals in India need to understand the concepts of molecular genetics to stay up-to-date with clinical care as well as to strengthen basic research in the biomedical sciences. Methods. We introduced a modular course on ‘Fundamentals in molecular and cellular biology’ for first-year medical undergraduate students in the second semester of the first MBBS year in 2015, as part of ‘Innovations in teaching physiology’ at St John’s Medical College. This was a voluntary, add-on course with didactic lectures, hands-on practical classes and a research paper presentation. Evaluation of students’ performance in the course took into account their performance in the research paper presentation-based group activity and their attendance for the hands-on practical sessions. Feedback on the content, delivery, evaluation and future improvements of the course was sought from the students. Results. About 65% of students regularly attended the 10-hour long course. Of the students evaluated for the course, 43% achieved the highest, and 11% achieved the lowest grade assigned. Nearly 72% of the students provided feedback on the course. Conclusion. This first outing of the modular course on ‘Fundamentals in molecular and cellular biology’ generated excitement among the students and achieved some learning for them. It also brought to light hidden challenges in conducting such a voluntary course for medical students in India. Our experience with the course will help in designing a better-integrated course for exposure of first-year medical students to advances in molecular biology and its applied aspects as they progress through the MBBS course.
  - 981 218
News From Here And There
PM Nischal
July-August 2018, 31(4):255-256
  - 473 100
Naveen Kumar Channaveerachari
July-August 2018, 31(4):241-241
DOI:10.4103/0970-258X.258229  PMID:31134935
  - 730 118
Surveillance of maternal deaths in Barpeta district of Assam
Swapna D Kakoty, Priyanka Das
July-August 2018, 31(4):206-210
DOI:10.4103/0970-258X.258218  PMID:31134924
Background. Assam has the highest maternal mortality in India. It is difficult to make a precise estimate of maternal mortality because the available information from various surveys has a wide confidence interval. Biomedical causes of maternal mortality are known, but there is little information on determinants of sociocultural and health system aspects. Delays at various levels such as at home (first level), during transportation (second level) and at hospital (third level) operate in a maternal death. Information on these determinants will give a better understanding of the circumstances of death. We aimed to estimate the maternal mortality ratio of Barpeta district in Assam and to understand the sociocultural factors and delays at various levels, which contribute to maternal death. Method. We did a community-based, cross-sectional study. During the surveillance period of 1 year, all maternal deaths occurring in the district were identified from multiple sources and informants. These included all deaths occurring in the health facility or in the community. In 50% of such deaths, social autopsy was conducted. The data were analysed manually for descriptive statistics and thematic areas. Results. The maternal mortality ratio of the district is 225 per 100 000 live-births. About 95% of respondents availed antenatal services and 57% delivered in hospital. The routine maternal death surveillance system is sensitive and detected 94% of maternal deaths. However, community-based verbal autopsy is yet to be functional. Most maternal deaths occur among women from low socioeconomic conditions. Delay at the first level occurred in 10 maternal deaths, at the second level in 18 maternal deaths and at the third level in 8 maternal deaths. Conclusions. Health-seeking behaviour is favourable and 90% of mothers sought services. Improved and functioning infrastructure will ensure better transportation facilities and early referral to a secondary- or tertiary-level health facility, which can prevent many maternal deaths.
  - 2,266 605
Robot-assisted versus laparoscopic radical nephrectomy
Ashwin S Tamhankar, Gagan Gautam
July-August 2018, 31(4):221-222
DOI:10.4103/0970-258X.258222  PMID:31134928
  - 963 252
A system of care for patients with ST-segment elevation myocardial infarction in India
Siddharthan Deepti, Ambuj Roy
July-August 2018, 31(4):222-223
DOI:10.4103/0970-258X.258223  PMID:31134929
  - 1,105 283
Use of information on pre-packaged foods among residents of an urban village of South Delhi, India
Meenakshi Bhilwar, Poornima Tiwari, Sunil Kumar Saha, Priyanka Sharma, Pragyan Paramita Parija
July-August 2018, 31(4):211-214
DOI:10.4103/0970-258X.258219  PMID:31134925
Background. With rapid urbanization and hectic lifestyle, there is a growing demand of pre-packaged food items. ‘Food label’, present on most packaged food items provides information about the contents, their nutritive value and other information that can help the consumer to make an informed choice. Few studies in India have assessed the consumer’s knowledge and practices related to information on a food label. Methods. We assessed the awareness, perceptions and practices related to the use of information on food labels among residents of an urbanized village of south Delhi. House-to-house visits were made and information gathered using a pre-designed, pre-tested, semi-structured questionnaire. Descriptive analysis was done and logistic regression performed to document the determinants of ‘reading food label’ by the study participants. Results. A total of 368 individuals were interviewed. The mean (SD) age of the participants was 29.1 (9.7) years. Around one-fourth (97/368; 26.4%) of all participants reported buying pre-packaged foods daily. A majority (222/ 368; 60%) of participants bought pre-packaged foods because they liked the taste, and also because they were easily available (153/368; 41.7%). A total of 64.1% (236/368) reported that they read food labels, but a majority checked only for the manufacture and expiry dates (203/236; 86%). Educational status, socioeconomic status and body mass index of the study participants were found to be significantly associated with reading of labels. Conclusions. The intention of promoting healthy food choices through the use of food labels is met inadequately at present. Awareness generation activities would be required to improve this behaviour.
  - 1,580 483
Do we care? India’s public healthcare: A viewpoint from the bottom of the pyramid
T Sudhakar Bhat
July-August 2018, 31(4):237-238
DOI:10.4103/0970-258X.258227  PMID:31134933
  - 1,058 370