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   2019| March-April  | Volume 32 | Issue 2  
    Online since January 7, 2020

 
 
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MEDICINE AND SOCIETY
Influenza A (H1N1) in India: Changing epidemiology and its implications
Sanket Vasant Kulkarni, Jai P Narain, Sunil Gupta, Akshay C Dhariwal, Sujeet Kumar Singh, C Raina Macintyre
March-April 2019, 32(2):107-108
DOI:10.4103/0970-258X.253355  PMID:31939410
  14,500 486 7
REVIEW ARTICLE
Active case-finding for tuberculosis in India
Giridharan Prathiksha, Bella Devaleenal Daniel, Mohan Natrajan
March-April 2019, 32(2):90-95
DOI:10.4103/0970-258X.275349  PMID:31939405
Early identification of presumptive tuberculosis (TB) cases through active case-finding (ACF) would be an important complementary strategy to meet the national urgency in accelerating case detection to achieve the goals of 'End TB' strategy. ACF activities have yielded additional cases in different vulnerable groups in India. The yield of cases depends on the screening tool available, the characteristics of the high-risk population being screened, and most importantly, the linkage between effective diagnostic and treatment facilities. The ACF strategy could be both economically and epidemiologically relevant if it could bring down the level of transmission. This needs long-term research focusing on outcomes such as cases averted and reduction in the prevalence of the disease. Available evidence suggests that ACF is likely to be feasible in Indian settings but needs to be scaled up rapidly to create a good impact.
  1,943 260 -
ORIGINAL ARTICLES
Prevalence and correlates of elder abuse: A cross-sectional, community-based study from rural Puducherry
Archana Ramalingam, Sonali Sarkar, KC Premarajan, Ravi Philip Rajkumar, DK Subrahmanyam
March-April 2019, 32(2):72-76
DOI:10.4103/0970-258X.275344  PMID:31939400
Background. Elder abuse is a neglected problem and needs to be addressed to improve the quality of life (QoL) of the elderly. We aimed to study the correlates of elder abuse in rural Puducherry. Methods. We conducted a cross-sectional, communitybased study among all the elderly people (60 years and above), from one of the four villages of a rural primary health centre in Puducherry. Participants were contacted at their homes. After obtaining consent, data were collected using (i) a structured, pre-tested questionnaire on sociodemographic details; (ii) elder abuse using the Hwalek-Sengstock Elder Abuse Screening Test; and (iii) QoL using WHO QoL-BREF. Multivariable logistic regression was used to identify predictors of elder abuse. Results. Of the 243 elderly individuals studied, 63% were women. The prevalence of elder abuse was 50.2%. On multivariable analysis, elderly with higher education status were found to have lower odds for suffering from abuse (primary education odds ratio [OR] 0.39 [0.18-0.84]; middle school OR 0.35 [0.14-0.86]; high school OR 0.08 [0.01-0.4]) compared to those with no formal education and those above 80 years of age were found to have higher odds for abuse (OR 3.02 [1.1-7.9]) compared to those <80 years, after adjusting for confounders such as sex, socioeconomic status, marital status and living arrangement. Conclusion. Half the elderly in our sample suffered from abuse. The higher age group and absence of formal education emerged as independent predictors of elder abuse.
  1,905 288 -
CLINICAL CASE REPORTS
Weil syndrome causing autoimmune haemolytic anaemia
Rahul Sai Gangula, M Mukhyaprana Prabhu, Weena Stanley
March-April 2019, 32(2):88-89
DOI:10.4103/0970-258X.275913  PMID:31939404
Weil syndrome is a fulminant form of leptospirosis, usually caused by spirochetal organism Leptospira interrogans. It is characterized by icterus, petechial rashes over the body, signs of renal failure and hepatic failure. Anaemia is a usual manifes- tation of Leptospira infection, but autoimmune haemolytic anaemia is rare. We report a patient with autoimmune haemolytic anaemia following Leptospira infection, which was responsive to high-dose steroid therapy.
  1,325 193 -
ORIGINAL ARTICLES
Intimate partner violence against Iranian women
Abolfazl Mohammadbeigi, Mahbobeh Sajadi, Robabeh Ahmadli, Azadeh Asgarian, Salman Khazaei, Sima Afrashteh, Hossein Ansari
March-April 2019, 32(2):67-71
DOI:10.4103/0970-258X.275343  PMID:31939399
Background. WHO has identified intimate partner violence (IPV) as a health priority as it has considerable consequences on the physical and psychological health of women. We aimed to evaluate the prevalence of IPV in women of one of the central cities of Iran in addition to examining the effect of a women's job and spousal addiction on IPV. Methods. We did a cross-sectional study on 240 homemakers and nurse women, selected by a multistage random sampling method. Data were collected by a modified version of domestic violence CTS-2 of Straus questionnaire and were analysed by chi-square test and t test. Multivariate logistic regression was used to assess the predictors of physical IPV as the most important type of violence. Results. The mean (SD) age of the women and their husbands was 33.1 (8) and 37.8 (8.7) years, respectively. Verbal (95.4%) and psychological (80.8%) violence were the most common while injury (14.6%) was the least prevalent. The prevalence of physical violence was 28.8%. Based on the regression model, economic problems, history of divorce in the woman's family and spousal addiction were the highest predictors of violence (p<0.05). Discussion. Spousal addiction was related to higher violence against women in physical, psychological and injury dimensions. Increase of family support, removal of economic disparities and tackling drug addiction could be effective in decreasing violence.
  1,093 223 -
SELECTED SUMMARIES
Selective Janus kinase inhibitors: Promising drugs for rheumatoid arthritis
Abhishek Zanwar, Amita Aggarwal
March-April 2019, 32(2):96-97
DOI:10.4103/0970-258X.275350  PMID:31939406
  1,140 154 -
MEDICAL EDUCATION
Health research methodology workshop: Evaluation with the Kirkpatrick model
Vinoth Gnana Chellaiyan, Rizwan Abdulkader Suliankatchi
March-April 2019, 32(2):100-102
DOI:10.4103/0970-258X.275352  PMID:31939408
Background. Workshops on research methodology impart skills of research among medical students. Both qualitative and quantitative evaluation of an academic programme is essential to enhance the effectiveness and quality improvement. We assessed the gain in learning and effect of a workshop on research methodology among medical students. Methods. We did a quasi-experimental, single-group study at a tertiary care hospital and research institute in southern India. It included 33 students enrolled in various residency positions of the institute. The Kirkpatrick 4-level model was used to assess the effectiveness of the workshop on research methodology. Paired t-test was used to compare pre- and postworkshop scores. Results. Twenty-five students rated the academic sessions as excellent. The score before the workshop ranged from 0 to 17 with mean (SD) 9.27 (4.2). The post-workshop score had a minimum to maximum score of 10-26 with mean (SD) of 16.18 (3.7) (p<0.005). The effect size d cohen (confidence interval [CI]) was 1.743 (0.942-2.545). The mean (SD) of absolute and relative gain was 10.8 (3.8) and 1.41 (0.07), respectively. 66.7% medical students showed a 30% rise in their post-workshop scores, the cut-off for effectiveness of the workshop. Conclusion. The evaluation of a workshop on research methodology provided insights into the outcomes and modifications required for their future improvement.
  1,076 200 -
MEDICINE AND SOCIETY
Road traffic injuries: Epidemiology, challenges and initiatives in India
Kuru Dindi, Damodar Bachani, Maneesh Singhal, Angel Rajan Singh
March-April 2019, 32(2):113-117
DOI:10.4103/0970-258X.275355  PMID:31939412
  1,062 189 -
ORIGINAL ARTICLES
Feasibility of mobile telephonic follow-up among patients with alcohol dependence syndrome
Munaf Nandyal, Susmita Chandramouleeswaran, Deepa Braganza
March-April 2019, 32(2):77-82
DOI:10.4103/0970-258X.275345  PMID:31939401
Background. Losses to follow-up impact the collection of outcomes among patients with alcohol dependence syndrome (ADS). We aimed to study the feasibility and acceptability of using telephonic contact as a means of following up new patients with ADS. The outcomes assessed were complete abstinence at the end of 6 months and associated factors. Methods. We followed up a cohort of 54 new patients diagnosed with ADS after 6 months, in the psychiatry department of a tertiary care hospital in India. We also assessed sociodemographic, alcohol-related, medical and treatmentrelated details of the patients; and scores on the Short Alcohol Dependence Data Questionnaire, Rotter's scale for the locus of control, and the Clinical Institute of Withdrawal Assessment of Alcohol scale-revised. The primary outcome was complete abstinence at the end of 6 months. The data at follow-up were collected through a combination of in-person and telephonic interviews with the patients and caregivers and supplemented with chart reviews. Results. Follow-up at 6 months could be carried out for 51 of 54 patients enrolled (94.4%; 32 through direct, and 19 through telephonic interviews). The proportion of patients who achieved and maintained complete abstinence during this period was 27.5%. The factors found to be associated with abstinence were regularity of follow-up, adherence to medicines and having had the habit of drinking alcohol with friends, as opposed to solitary drinking. Conclusion. Using mobile telephonic technology, we were able to obtain an excellent follow-up and improve the collection of outcomes by 35.2% at the end of a 6-month period among new patients with ADS. This potentially effective tool is widely available and cost-effective, and could have a role in improving outcomes among patients with ADS.
  1,000 176 -
CLINICAL CASE REPORTS
Ketamine as a potential option in the treatment of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing
Arun Aggarwal
March-April 2019, 32(2):86-87
DOI:10.4103/0970-258X.275347  PMID:31939403
A number of treatment options have been used over the years in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) with variable results. The most common preventive treatments include carbamazepine, lamotrigine, indomethacin, gabapentin and topiramate. Ketamine is being increasingly used in the treatment of neuropathic pain. The parentral formulations are generally used as oral preparations have poor bioavailability. Recently, ketamine lozenges have been shown to have sufficiently high bioavailability to support their use as a preventive treatment in a number of conditions causing intractable neuropathic pain. We report a 58-year-old man whose symptoms of SUNCT were not responsive to conventional preventive treatments but responded well to a subcutaneous, sub-anaesthetic ketamine infusion and subsequently, sublingual ketamine lozenges.
  799 152 -
EDITORIAL
Mobile Telephones to Improve Mental Health Care
Sudhir K Khandelwal
March-April 2019, 32(2):65-66
DOI:10.4103/0970-258X.275342  PMID:31939398
  760 181 -
SHORT REPORT
Is histopathological examination of sleeve gastrectomy specimens necessary in areas endemic for gastric cancer?
Santosh Anand, Raja Kalayarasan, Sandip Chandrasekar, Pazhanivel Mohan, Biju Pottakkat, Senthil Gnanasekaran
March-April 2019, 32(2):83-85
DOI:10.4103/0970-258X.275346  PMID:31939402
Background. The value of histopathological examination of a laparoscopic sleeve gastrectomy (LSG) specimen in areas endemic for Helicobacter pylori (H. pylori) and gastric cancer is not known. We assessed the histopathological findings of LSG specimens to determine whether routine histopathological examination of these would be useful in patients with normal preoperative upper gastrointestinal endoscopy findings in an area endemic for gastric cancer. Methods. We did a retrospective analysis of the histopathological findings of LSG specimens in patients who underwent the procedure between March 2015 and March 2017. We ascertained the association of positive histopathological findings with the clinical profile of patients and preoperative upper gastrointestinal endoscopy findings. Results. Twenty-six patients (16 females) with a mean age of 37.5 years underwent LSG during the study period. On preoperative upper gastrointestinal endoscopy, 18 patients had unremarkable findings. Of the three patients with gastric or duodenal erosions on upper gastrointestinal endoscopy, two had H. pylori infection. On histopathological examination, 14 patients had unremarkable findings. Chronic gastritis with or without follicle formation was the most common finding (n=7). None of the patients with normal upper gastrointestinal endoscopy findings had significant histopathological findings or evidence of H. pylori infection. No significant association was found between age, gender, body mass index, smoking and alcohol intake with positive histopathological findings (p=0.64, 0.91, 0.90, 0.10 and 0.94, respectively). Conclusions. We did not find clinically important histopathological findings on routine examination of the LSG specimen in bariatric patients with normal preoperative upper gastrointestinal endoscopy findings.
  765 151 -
MEDICINE AND SOCIETY
Indian healthcare at crossroads (Part 2): Social and environmental influences
Anil C Anand
March-April 2019, 32(2):109-112
DOI:10.4103/0970-258X.275354  PMID:31939411
  746 89 -
IMAGES IN MEDICINE
Gas gangrene complicating an open fracture
Ramanuj Mukherjee, Madhav Parik, Pritha Roy, Gouri Mukhopadhyay
March-April 2019, 32(2):123-123
DOI:10.4103/0970-258X.275359  PMID:31939416
  661 131 -
BOOK REVIEWS
V.Q.E: The Tale of an Indian Physician in the United Kingdom of the 1980's.
Vivek Arya
March-April 2019, 32(2):124-124
DOI:10.4103/0970-258X.275360  
  653 63 -
MEDICAL EDUCATION
Effectiveness of problem-solving exercises in radiology education for undergraduates
CS Singh, KR Sethuraman, G Ehzumalai, BV Adkoli
March-April 2019, 32(2):103-106
DOI:10.4103/0970-258X.275353  PMID:31939409
Background. The teaching of radiology to undergraduates in India is largely didactic. We incorporated innovative methods including problem-solving exercises in teaching to assess the impact on the outcome with respect to knowledge and interpretive skills in radiology. Methods. We enrolled all students of the 2014-15 MBBS batch. The topics in radiology were divided in two parts. The first part was taught by innovative methods including problemsolving exercises and integrated teaching. The second part was taught by the conventional lecture method. Validated item banks were used to assess the increase in knowledge and interpretive skills developed by these modalities to compare their effectiveness. Results. Students showed an improvement in knowledge and interpretive skills scores irrespective of whether they we were taught by the innovative or conventional teaching method. However, the gain in scores were higher and statistically significant for interpretive skills when taught by the innovative teaching method. Conclusions. Innovative teaching methods that involve integrated teaching and use of problem-solving exercises and picture-archiving communicating system are beneficial for promoting interpretive and problem-solving skills of undergraduates in learning radiology.
  589 104 -
CORRESPONDENCE
Competency-based curriculum: Mirage or reality
Puja Dulloo
March-April 2019, 32(2):125-126
DOI:10.4103/0970-258X.275362  PMID:31939418
  568 105 -
SPEAKING FOR OURSELVES
Where the mind of a doctor is born…
Vidya Viswanath, Nandini Vallath
March-April 2019, 32(2):118-119
DOI:10.4103/0970-258X.275356  PMID:31939413
  547 97 -
SELECTED SUMMARIES
Aspirin prophylaxis: No magical single dose
Mohammad Ali, Ashish Sharma
March-April 2019, 32(2):97-99
DOI:10.4103/0970-258X.275351  PMID:31939407
  552 87 -
CORRESPONDENCE
Disappearing libraries
BC Rao
March-April 2019, 32(2):125-125
DOI:10.4103/0970-258X.275361  PMID:31939417
  493 78 -
LETTER FROM CHENNAI
Letter from Chennai
MK Mani
March-April 2019, 32(2):121-122
DOI:10.4103/0970-258X.275358  PMID:31939415
  414 54 -
LETTER FROM LONDON
Letter from London
Anna Ruddock
March-April 2019, 32(2):120-120
DOI:10.4103/0970-258X.275357  PMID:31939414
  347 65 -
NEWS FROM HERE AND THERE
News from here and there

March-April 2019, 32(2):127-128
DOI:10.4103/0970-258X.275363  
  307 71 -