Journal Of Postgraduate Medicine[JOURNAL]
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200 papers
VR Khanolkar's research and academic activities in K.E.M. Hospital and Seth G.S. Medical College.
Pai SA
J Postgrad Med · 2025 Jan · PMID 40085065 · Full text
Vasant Ramji Khanolkar was the first Professor and Head of Pathology at Seth Gordhandas Sunderdas Medical College and King Edward Memorial VII Hospital [GSMC] in Bombay (now Mumbai). Although he later gained internationa...
Vasant Ramji Khanolkar was the first Professor and Head of Pathology at Seth Gordhandas Sunderdas Medical College and King Edward Memorial VII Hospital [GSMC] in Bombay (now Mumbai). Although he later gained international recognition as a pathologist during his career at Tata Memorial Hospital, Bombay, after 1941, little is known about his scientific contributions during his years at GSMC. This article outlines his research and other academic activities at GSMC, with specific dates; his memberships in societies and the congresses he attended in India and Paris, France; and the examination patterns of the 1920s. Additionally, it highlights the personal interests that enriched his life.
The bitter aftertaste: Chronic pancreatitis and diabetes from codeine cough syrup.
Umarji GS, Alicheri AS, Chacko A … +1 more , Bhat S
J Postgrad Med · 2025 Jan · PMID 40047488 · Full text
Abstract loading — click title to view on PubMed.
2. Types of data and data collation for efficient processing.
Indrayan A
J Postgrad Med · 2025 Jan · PMID 40047487 · Full text
Data are the soul of most empirical research. Adequate data collection and their proper collation are essential to arrive at right conclusions. These conclusions are mostly drawn from the statistical analysis of properly...
Data are the soul of most empirical research. Adequate data collection and their proper collation are essential to arrive at right conclusions. These conclusions are mostly drawn from the statistical analysis of properly collated data. Since the methods of statistical analysis are different for different types of data, a clear understanding of various types of data is necessary for their efficient processing. Whereas broad types of data-quantitative and qualitative-are well known, some researchers struggle with the proper collation of ordinal data and quantitative categories. Additionally, some young researchers need guidance on preparing tables to communicate their results effectively. Graphics add muscles to the skeleton of data and need to be judiciously chosen. This article provides details of various types of data, their adequacy, and their proper collation, including a brief on tables and graphics. Almost all medical researchers carry out these activities - thus, this may have wide ramifications. Although this article primarily targets postgraduate students and young researchers, our interaction with a diverse group of researchers suggests that many experienced researchers may also find this article useful in the management of their data for reaching the right conclusions.
Assessing and managing iron deficiency anemia in sickle cell disease: Insights from a systematic review and meta-analysis.
Jose A, Bodade A, Madkaikar MR
J Postgrad Med · 2025 Jan · PMID 40047486 · Full text
Sickle cell disease (SCD) is prevalent in Sub-Saharan Africa, the Middle East, and parts of India, where it is often complicated by iron deficiency anemia (IDA). Untreated IDA exacerbates SCD symptoms, reducing quality o...
Sickle cell disease (SCD) is prevalent in Sub-Saharan Africa, the Middle East, and parts of India, where it is often complicated by iron deficiency anemia (IDA). Untreated IDA exacerbates SCD symptoms, reducing quality of life (QOL) and increasing morbidity and mortality. Diagnosis typically depends on ferritin levels, which can be unreliable due to inflammation associated with SCD's altered red cell morphology and chronic hemolysis. This systematic review and meta-analysis explores the interplay between IDA and SCD, focusing on diagnostic criteria for effective management. We conducted a thorough search of PubMed and EMBASE, leading to the selection of 14 studies following PRISMA guidelines. The review protocol was registered in PROSPERO (CRD42023462914). Data extraction, quality assessments, and heterogeneity checks were rigorously performed. Out of 3188 articles, 14 studies met the inclusion criteria, covering 763 SCD cases with 118 instances of IDA. The meta-analysis found an IDA prevalence of 6% (95% CI: 1%-20%) among SCD patients, with high heterogeneity (I 2 = 88.8%). Sensitivity analysis adjusted for publication bias indicated an 8% prevalence (95% CI: 4%-19%) with reduced heterogeneity (I 2 = 19.5%). Subgroup analysis revealed a lower prevalence of IDA in pregnant women (0.01%; 95% CI: 0.00%-0.92%) compared to non-pregnant individuals (7%; 95% CI: 2%-22%). The study highlights significant regional variability in IDA prevalence among SCD patients, emphasizing the importance of early diagnosis and targeted management to improve patient outcomes and QOL.
Microbial profile and antimicrobial resistance patterns in ventilator-associated pneumonia (VAP): A cross-sectional study from Syria.
Khalil KA, Alsultan M, Daher NA
J Postgrad Med · 2025 Jan · PMID 39745288 · Full text
INTRODUCTION: This study aimed to determine the bacterial profile and their antibiotic spectrum in patients with ventilator-associated pneumonia (VAP) and investigate the risk factors for VAP and the presence of multidru...
INTRODUCTION: This study aimed to determine the bacterial profile and their antibiotic spectrum in patients with ventilator-associated pneumonia (VAP) and investigate the risk factors for VAP and the presence of multidrug-resistant (MDR) pathogens. MATERIALS AND METHODS: A cross-sectional study was included 105 patients with clinically suspected VAP in intensive care units (ICUs) of two university hospitals from Syria, between January 2023 and February 2024. Culture-positive included 69 samples (65.7%), which were classified based on post-intubation as early-onset (<5 days) or late-onset (≥5 days). RESULTS: Gram-negative and Gram-positive bacteria were observed in 82.6% and 17.4%; respectively. Early and late-onset VAP was reported in 30 (43.5%) and 39 (56.5%) patients; respectively. The primary cause of early-onset VAP was Acinetobacter and Enterobacter , whereas Klebsiella and Acinetobacter were the main causes of late-onset VAP. Gram-negative showed a high resistance to fluoroquinolones (91.2%), carbapenems (78.9% for imipenem and 86% for meropenem), and amikacin (83.2%), while all were sensitive to colistin. Gram-positive was sensitive to tetracycline, vancomycin, linezolid, tigecycline, and trimethoprim-sulfamethoxazole. MDR was observed in 55 patients (79.7%) and in early (76.9%) and late-onset (83.3%) VAP. There were no risk factors favoring MDR or early compared to late-onset VAP. CONCLUSIONS: The study revealed a high prevalence of Gram-negative among VAP patients. A significant prevalence of MDR pathogens was observed in early and late-onset VAP, along with high resistance to carbapenems. This necessitates a reassessment of the current use of antibiotics and highlights the need for further studies to choose alternative treatments for empirical antibiotic coverage.
Assessment of the effectiveness and perception of different teaching techniques used in pharmacology among students.
Jaju TA, Parmar UI, Gajbhiye SV … +2 more , Kurle DG, Shah RM
J Postgrad Med · 2024 Oct · PMID 39670320 · Full text
INTRODUCTION: Pharmacology is one of the most dynamic and evolving branches, not only in the concepts but also in teaching methodologies. Many attempts have been made by various colleges all over the world to make the te...
INTRODUCTION: Pharmacology is one of the most dynamic and evolving branches, not only in the concepts but also in teaching methodologies. Many attempts have been made by various colleges all over the world to make the teaching of pharmacology more interesting and relevant. MATERIALS AND METHODS: The literature from two databases (Google Scholar and PubMed) published between 2005 and 2020 were searched using terms related to "Teaching Techniques" AND "Pharmacology." The articles with unavailable full-text those published in conference proceedings, duplicate studies, and articles published in languages apart from English were excluded. Teaching techniques were compared using success and popularity ratios, which were calculated on the basis of student's test score and their feedback with an average minimum score of 50%, which was considered the benchmark. RESULTS: Out of the 1,093 articles reviewed, only 95 studies met the inclusion criteria. The majority of the studies were conducted among medical (64.21%) and pharmacy (28.42%) students. Most common teaching techniques belonged to computer and case-based (21.05% each) types followed by multiple techniques (11.58%) types. Flipped, case-based, multiple methods, modules, and other innovative methods have been well received by students with a popularity ratio ranging between 100 and 81, and improvement in students' test scores further demonstrated their utility with a success ratio between 100 and 88. The effectiveness and popularity of computer-based techniques and student-centered techniques were found to be moderate (73 and 71). Although popular, team-based techniques and simulations seemed to be less effective in improving test scores (50 and 33, respectively). CONCLUSION: There is a need for periodic up-gradation in techniques utilized for teaching pharmacology. Every teaching technique has its strengths and weaknesses. They need to be utilized as per the student's requirement.
Analysis of deaths due to gender-based violence: An autopsy-based cross-sectional study from Mumbai.
Pathak HM, Kaur A, Chaudhary N … +1 more , Paul AS
J Postgrad Med · 2024 Oct · PMID 39670312 · Full text
INTRODUCTION: Gender-based violence (GBV), including domestic violence, honor killings, and dowry deaths, represents one of the most extreme forms of violence against women. These deaths are often misclassified as accide...
INTRODUCTION: Gender-based violence (GBV), including domestic violence, honor killings, and dowry deaths, represents one of the most extreme forms of violence against women. These deaths are often misclassified as accidents or suicides due to societal biases, leading to underreporting and obscuring the true impact of GBV on women's mortality. AIMS AND OBJECTIVES: This study aimed to evaluate the prevalence of GBV-related deaths, with a focus on cases misreported as accidents or suicides. The objective was to determine the proportion of female deaths attributable to GBV and to highlight the challenges in reporting and investigating these cases. MATERIALS AND METHODS: A retrospective, cross-sectional study was conducted at a medical teaching institution in Mumbai, analyzing 5 years (May 2017-April 2022) of autopsy data involving unnatural female deaths. Autopsy records, police reports, and victim/relative statements were examined to identify potential GBV cases and discrepancies in death classification. RESULTS: The study found a significant proportion of female deaths attributed to GBV, primarily within domestic settings. Many cases initially reported as accidents or suicides showed discrepancies in injury patterns and circumstances. The majority of GBV victims were young women aged 15-44 years, with burns being the most common cause of death. CONCLUSION: The study emphasizes the need for improved investigation and classification of unnatural female deaths. Domestic violence emerged as the most common factor in these deaths, with intimate partners being primary perpetrators, with most incidents occurring within the home. It also stresses on enhanced protocols to accurately identify and address GBV-related fatalities.
1. Study designs for making most of the limited resources.
Indrayan A
J Postgrad Med · 2024 Oct · PMID 39660579 · Full text
Medical research is costly and requires significant effort. While intracellular research hardly follows a formal design, most data-based studies require a structural approach for optimal utilization of resources. Dependi...
Medical research is costly and requires significant effort. While intracellular research hardly follows a formal design, most data-based studies require a structural approach for optimal utilization of resources. Depending on the study's objectives and available resources, as well as the aim to obtain valid and reliable results, the design may be descriptive, employing specific sampling strategies, or analytical, exploring antecedent-outcome relationships. Analytical studies often involve designs such as randomization and blinding in clinical trials, and may use prospective, retrospective, or cross-sectional designs in observational studies. This first article in the series on biostatistics methods specifies the essential features of each design and describes the contexts in which they are most appropriate.
Navigating healthcare leadership: Theories, challenges, and practical insights for the future.
Singh PK, Singh S, Kumari V … +1 more , Tiwari M
J Postgrad Med · 2024 Oct · PMID 39660574 · Full text
Effective healthcare leadership is essential to ensure high-quality patient care and foster a supportive work environment for healthcare professionals. This review aims to consolidate existing healthcare leadership liter...
Effective healthcare leadership is essential to ensure high-quality patient care and foster a supportive work environment for healthcare professionals. This review aims to consolidate existing healthcare leadership literature to provide evidence-based insights that can guide leadership development, improve team performance, and enhance patient care outcomes. A systematic search of academic databases such as PubMed, Scopus, Web of Science, CINAHL, Embase, and Google Scholar was performed using keywords related to healthcare leadership. Studies were selected based on their relevance, peer-reviewed status, and focus on healthcare settings. Thematic analysis was employed to synthesize findings from the selected studies. The review explores various leadership theories, including Great Man, trait, behavioral, transactional, transformational, and contingency theories, highlighting their relevance and application in healthcare. Effective healthcare leaders must possess traits such as vision, emotional intelligence, adaptability, and ethical integrity to navigate the complexities of modern healthcare. The review categorizes different leadership styles, including authoritarian, transformational, transactional, servant, and participative, and discusses their application in specific healthcare contexts. Leaders face challenges such as balancing personal and professional responsibilities, adapting to technological advancements, managing financial constraints, and ensuring regulatory compliance. Healthcare leadership requires a dynamic and adaptable approach that integrates various leadership theories and styles to address the unique challenges of the healthcare environment. This review underscores the importance of leadership development programs and calls for further research to explore the practical implementation of leadership strategies in diverse healthcare settings. The findings provide actionable insights for healthcare leaders to tailor their leadership styles to the specific needs of their teams and organizational contexts, ultimately enhancing patient care and operational efficiency.
Fatal familial insomnia: Reporting a case of the rare nightmare.
Hogue E, Weinberg D, Palecek E
J Postgrad Med · 2024 Oct · PMID 39660573 · Full text
Prion diseases are rare, incurable, and rapidly progressive. Pathogenic misfolded proteins accumulate in the central nervous system causing fatal neurodegeneration. Fatal familial insomnia (FFI) is an even rarer, heredit...
Prion diseases are rare, incurable, and rapidly progressive. Pathogenic misfolded proteins accumulate in the central nervous system causing fatal neurodegeneration. Fatal familial insomnia (FFI) is an even rarer, hereditary subset of prion disease. The initial clinical course is nonspecific, leading to difficulties with diagnosis. We describe a patient with a family history of prion disease who presented with early symptoms of FFI including disordered sleep, cognitive dysfunction, and autonomic dysregulation. Notably, diagnostic studies including magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and electroencephalography (EEG) did not show changes characteristic of prion disease. However, genetic testing showed a pathological, heterozygous mutation c.532G> A (p.Asp178Asn), confirming FFI. His clinical course progressed rapidly, and death occurred several months after the initial hospital presentation. We discuss the pathophysiology and diagnosis of FFI and the emotional care required to treat this fatal disease. General practitioners should be aware of this rare diagnosis to improve patient management.
A case of mesalamine potentiating hypoprothrombinemic effect of vitamin K antagonist (VKA) therapy resulting in life-threatening bleeding.
Prabhu RS, Rahmathullah SN, Ahammad J
J Postgrad Med · 2024 Oct · PMID 39660571 · Full text
A 76-year-old male patient, who underwent a post-aortic valve replacement with a mechanical valve in 2006, was on oral anticoagulant therapy with warfarin, maintaining a stable therapeutic level of anticoagulation until...
A 76-year-old male patient, who underwent a post-aortic valve replacement with a mechanical valve in 2006, was on oral anticoagulant therapy with warfarin, maintaining a stable therapeutic level of anticoagulation until 2022. He had a new diagnosis of ulcerative colitis in 2022, following which he was started on mesalamine. He had been having a supratherapeutic level of anticoagulation, as evidenced by an international normalized ratio (INR) of 12 to 14 on multiple occasions since 2022, leading to gastrointestinal bleeding, necessitating multiple packed red cell transfusions. He presented to us in August 2024 with severe anemia due to gastrointestinal bleeding. The evaluation revealed severe depletion of vitamin K-dependent coagulation factors. In this report, we discuss the possible drug-drug interactions between mesalamine and vitamin K antagonists, which went unrecognized leading to life-threatening gastrointestinal bleeding.
Unveiling Balantidium coli : A rare protozoan causing a series of cases of dysentery in Rajasthan and review of literature.
Kataria S, Singla A, Sharma C
J Postgrad Med · 2024 Oct · PMID 39660569 · Full text
Balantidium coli is the largest, uncommon, and only ciliate parasite that infects humans and is more common in tropics and subtropical regions. It is mostly asymptomatic, but can cause diarrhea and abdominal pain and som...
Balantidium coli is the largest, uncommon, and only ciliate parasite that infects humans and is more common in tropics and subtropical regions. It is mostly asymptomatic, but can cause diarrhea and abdominal pain and sometimes leads to perforation of the colon. It is harbored in animals, particularly among pigs in hotter environments and monkeys in the jungles. If not treated on time, it may lead to perforation of the large intestine, peritonitis, appendicle involvement, etc. It is more common in immune-compromised individuals, particularly in those living in poor hygienic conditions. Retrieval of rare parasites was possible only because of prompt stool transport and its early processing. There are only few previous reports regarding the pediatric cases of balantidiasis, and there is a little information about its clinical signs and treatment. Here, we report a case series of B. coli infection presenting as an acute diarrheal disease from Rajasthan.
A randomized, double-blind, placebo controlled study to evaluate the effect of alpha-lipoic acid on inhibition of ADP-and collagen-induced platelet aggregation ex vivo in diabetic neuropathy patients on gabapentin or pregabalin.
Pingali U, Sravanasandya P, Mekala P … +3 more , Yareeda S, Sireesha K, Khan I
J Postgrad Med · 2024 Oct · PMID 39641383 · Full text
BACKGROUND: Diabetic peripheral neuropathy (DPN) is a chronic microvascular complication in diabetic mellitus patients due to chronic hyperglycemia, resulting in platelet hyperactivity and dyslipidemia. Alpha-lipoic acid...
BACKGROUND: Diabetic peripheral neuropathy (DPN) is a chronic microvascular complication in diabetic mellitus patients due to chronic hyperglycemia, resulting in platelet hyperactivity and dyslipidemia. Alpha-lipoic acid (ALA) is a potent antioxidant which has antiplatelet activity and lipid-modulating characteristics and plays a major role in the prevention of disease progression. AIM: To evaluate the effect of ALA on inhibition of platelet aggregation and lipid profile. SETTINGS AND DESIGN: This was a prospective, randomized, double-blind, placebo-controlled study conducted at the Department of Clinical Pharmacology and Therapeutics at a tertiary care hospital. MATERIALS AND METHODS: We recorded efficacy parameters including changes in inhibition of platelet aggregation, lipid profile, blood sugars, and glycated hemoglobin over 12 weeks of ALA (600 mg once daily orally) supplementation in DPN patients on gabapentin (300 mg twice daily [BD]) or pregabalin (75 mg BD) compared to placebo. We used Student's t-test paired and unpaired for within-group and between-group comparisons, respectively. RESULTS: A total of 52 study participants (males = 22, females = 30) with a mean age 55.63 ± 7.5 years were randomized to receive either ALA or placebo. Between-group analysis at 12 weeks showed that ALA significantly inhibited both collagen-induced platelet aggregation (from 32.61 ± 8.00 to 24.88 ± 5.30; P < 0.001) and adenosine diphosphate-induced platelet aggregation (from 34.00 ± 6.97 to 25.96 ± 6.45; P < 0.001) compared to placebo. Significant reduction in total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, and triglycerides was found in the ALA group at 12 weeks compared to baseline. No serious adverse events were reported. CONCLUSION: ALA, an antioxidant, demonstrated a protective effect against DPN by the virtue of its inhibitory effect on platelet aggregation and lipid-modulating effects and was found to have good safety.
Prediction of mortality in sepsis patients using stacked ensemble machine learning algorithm.
Babu M, Sappani M, Joy M … +3 more , Chandiraseharan VK, Jeyaseelan L, Sudarsanam TD
J Postgrad Med · 2024 Oct · PMID 39641373 · Full text
INTRODUCTION: Machine learning (ML) has been tried in predicting outcomes following sepsis. This study aims to identify the utility of stacked ensemble algorithm in predicting mortality. METHODS: The study was a cohort o...
INTRODUCTION: Machine learning (ML) has been tried in predicting outcomes following sepsis. This study aims to identify the utility of stacked ensemble algorithm in predicting mortality. METHODS: The study was a cohort of adults admitted to a medical unit of a tertiary care hospital with sepsis. The data were divided into a training data set (70%) and a test data set (30%). Boruta algorithm was used to identify important features. In the first phase of stacked ensemble model, weak learners such as random forest (RF), support vector machine (SVM), elastic net, and gradient boosting machine were trained. The SVM was used in phase 2 as meta learner to combine the results of all weak learners. All models were validated using test data. RESULTS: In our cohort of 1,453 patients, the mortality rate was 27% (95% confidence interval [CI]: 25, 29). The Boruta algorithm identified inotrope use and assisted ventilation as the most important variables, which could predict mortality. The random forest outperforms (area under the curve [AUC]: 97.91%) the other algorithms. The AUCs for the other models are SVM (95.21%), GBM (93.67%), and GLM net (91.42%). However, the stacking of all the above models had an AUC of 92.14%. In the test data set, the accuracy of all methods including the RF method accuracy decreased (92.6 to 85.5%). CONCLUSIONS: The random forest showed high accuracy in train and moderate accuracy in the test data. We suggest more regional open-access intensive care databases that can aid making machine learning a bigger support for healthcare personnel.
Revealing inducible clindamycin resistance in methicillin-resistant S aureus : A vital diagnostic imperative for effective treatment.
Bawankar NS, Agrawal GN, Zodpey SS
J Postgrad Med · 2024 Oct · PMID 39611413 · Full text
INTRODUCTION: The World Health Organization added methicillin-resistant S aureus (MRSA) to the list of "priority pathogens," given its capacity to cause life-threatening infections. Clindamycin is a preferred treatment f...
INTRODUCTION: The World Health Organization added methicillin-resistant S aureus (MRSA) to the list of "priority pathogens," given its capacity to cause life-threatening infections. Clindamycin is a preferred treatment for non-complicated S aureus-induced skin and soft tissue infections. Its good tissue penetration and oral absorption make it suitable for outpatient therapy. However, the emergence of inducible and constitutive (MLS B ) resistance led to clinical challenges, primarily due to the potential oversight of inducible resistance in routine antimicrobial sensitivity testing. MATERIALS AND METHODS: This cross-sectional study was conducted at a tertiary care hospital during 2020-2022. A total of 158 MRSA isolates from various clinical specimens were analyzed. The Kirby-Bauer disk diffusion method using cefoxitin disk and D-test were used to identify MRSA and detect inducible clindamycin resistance (ICR), respectively. RESULTS: Among the 158 MRSA isolates, 34.17% showed constitutive clindamycin resistance (MLS B c), while 22.15% displayed ICR (MLS B i). In addition, 10.13% of isolates demonstrated the MS phenotype, clindamycin, and erythromycin susceptibility, with 53 (33.54%) isolates susceptible to both antibiotics. The relative risk of clindamycin treatment failure was 7.66 times higher if the D-test was not used. CONCLUSION: To prevent clindamycin treatment failures, the D-test must be implemented to detect ICR in MRSA isolate. Neglecting simple and cost-effective tests may lead to inaccurate susceptibility reporting, jeopardizing treatment success.
Left ventricular pacing in a young African patient with a metallic tricuspid valve and infected epicardial leads: A case report.
Singhal MP, Udyavar A
J Postgrad Med · 2024 Oct · PMID 39611410 · Full text
Tricuspid valve pathology is a relatively common anomaly. In patients with mechanical tricuspid valve replacement, implantation of a permanent pacemaker can be challenging due to the risk of valve damage, failure, and le...
Tricuspid valve pathology is a relatively common anomaly. In patients with mechanical tricuspid valve replacement, implantation of a permanent pacemaker can be challenging due to the risk of valve damage, failure, and lead fracture associated with right ventricular endocardial leads. Epicardial leads may be an option, but they require a surgical procedure and are not preferred in patients with prior thoracotomy. This case report aims to demonstrate the safety and feasibility of left ventricular (LV) pacing via the coronary sinus (CS) in a 30-year-old young female with a mechanical tricuspid valve and infected epicardial leads. Due to the complications and contraindications of traditional approaches, Lead implantation via the CS was utilized. This method allowed for successful pacemaker implantation, demonstrating the feasibility and safety of LV pacing in such complex cases. The use of CS-guiding catheters and specialized leads facilitated effective cannulation and stable, reliable pacing, avoiding the need for further invasive surgeries.
Pancreatic signet-ring cell carcinoma (the rare) with urinary bladder metastasis (the rarer).
Vaideeswar P, Kolhe S
J Postgrad Med · 2024 Oct · PMID 39611403 · Full text
Abstract loading — click title to view on PubMed.
Utility of interactive videogame in allaying preoperative anxiety in pediatric surgical patients - A randomized controlled study.
Vinay AP, Karna ST, Ahmad Z … +3 more , Waindeskar V, Ahmed R, Kuttan KA
J Postgrad Med · 2024 Oct · PMID 39611402 · Full text
INTRODUCTION: Non-pharmacological distraction using video games (VG) is still under-explored in pediatric surgical patients. MATERIALS AND METHODS: We conducted this randomized controlled study of 150 children, aged 4-12...
INTRODUCTION: Non-pharmacological distraction using video games (VG) is still under-explored in pediatric surgical patients. MATERIALS AND METHODS: We conducted this randomized controlled study of 150 children, aged 4-12 years, scheduled for elective surgery in a tertiary care hospital to estimate the distractive effect of VG on immediate preoperative anxiety in children. In the intervention group (I), playing with VG was encouraged till anesthetic induction. The control group (C) received usual care with verbal reassurance. Modified Yale preoperative anxiety scale (mYPAS) score and presence of anxiety (mYPAS >30) were noted in the preoperative area (T1), at parental separation (T2), and anesthetic induction (T3). Parental separation anxiety score (PSAS) >3 was considered unacceptable parental separation. We used the Mann-Whitney test and t-test to find significance of intergroup mean difference of anxiety and logistic regression to find risk factors for immediate preoperative anxiety. RESULTS: The mean m-YPAS (±SD) scores at T1 and T2 were 38 (±10.9) and 52.2 (±18.7) in group C and 46.5 (±13.5) and 33 (IQR: 28.3-65.5) in group I, respectively. The incidence of anxiety at T2 was higher in group C (81.3%) than in group I (59%). More children in group I (53/75) had acceptable separation than in group C (32/75) (P = 0.001). VG led to a 2.32 times lower risk of anxiety at T2 (P = 0.036). In children with acceptable separation, the incidence of anxiety was lower in group I (59%) than in group C (87%). CONCLUSION: VG-based distraction effectively reduced preoperative anxiety in children undergoing elective surgeries.
Quantity over quality of publications: Are we using the right metrics to judge author's productivity and impact in biomedical research?
Verma S, Sharma H
J Postgrad Med · 2024 Jul · PMID 39150743 · Full text
The "publish and flourish" culture in the biomedical field has led to an increase in the number of publications worldwide, creating pressure on researchers to publish frequently. However, this focus on quantity over qual...
The "publish and flourish" culture in the biomedical field has led to an increase in the number of publications worldwide, creating pressure on researchers to publish frequently. However, this focus on quantity over quality has resulted in an inflation of the number of authors listed in articles, leading to authorship issues and the rise of fraudulent or predatory scientific and medical journals. To maintain the credibility of scientific research, it is necessary to reform the publication metrics and explore innovative ways of evaluating an author's contributions. Traditional metrics, such as publication counts, fail to capture the research's quality, significance, and impact. As a result, this viewpoint explores and highlights different metrics and novel methods by which an author's productivity and impact can be assessed beyond traditional metrics, such as the H index, i10 index, FWCI, HCP, ALEF, AIF, AAS, JIF, CNA, awards/honors, citation percentile, n-index, and ACI. By using multiple metrics, one can determine the true impact and productivity of an author, and other measures such as awards and honors, research collaborations, research output diversity, and journal impact factors can further aid in serving the purpose. Accurately assessing an author's productivity and impact has significant implications on their academic career, institution, and the broader scientific community. It can also help funding agencies make informed decisions, improve resource allocation, and enhance public trust in scientific research. Therefore, it is crucial to address these issues and continue the ongoing discussion on best method to evaluate and recognize the contributions of authors in today's rapidly changing academic landscape.
Comparison of C-MAC ® conventional blade, D-Blade ™ , and Macintosh laryngoscopes for endotracheal intubation in patients with simulated immobilization using manual in-line stabilization: A randomized trial.
Dabas M, Gupta M, Mohanan S … +2 more , Kaushik P, Lall R
J Postgrad Med · 2024 Jul · PMID 39140638 · Full text
BACKGROUND: A difficult airway is anticipated with cervical spine injuries (CSIs) as immobilization techniques such as manual in-line stabilization (MILS) are used, which distort the oro-pharyngeal-laryngeal axis. Video...
BACKGROUND: A difficult airway is anticipated with cervical spine injuries (CSIs) as immobilization techniques such as manual in-line stabilization (MILS) are used, which distort the oro-pharyngeal-laryngeal axis. Video laryngoscopes (VLs) make difficult airway management easy, as they do not require axis alignment. The present study aimed to compare the total time taken by Macintosh laryngoscope (ML), conventional blade, and D-blade ™ of C-MAC ® VL in simulated CSI scenarios using MILS. METHODS: Ninety patients were randomly allocated into three groups: Group M (ML), Group C (conventional blade of C-MAC ® ), and Group D (D-blade ™ of C-MAC ® ) with MILS applied before intubation. Primary outcome was the total time taken for successful intubation, while secondary outcomes were to assess Cormack-Lehane (CL) grade, number of attempts, hemodynamic response, and associated complications. RESULTS: Total time for intubation in Group C was 23.40 ± 7.06 sec compared to 35.27 ± 6.53 and 47.27 ± 2.53 sec in groups D and M, respectively ( P < 0.001). CL-grade I was observed in 15/30 (50%) in Group M, 25/30 (83.3%) in Group C, and 29/30 (96.7%) in Group D. Group M reported 7/30 (23.3%) failed intubations, while none were observed in other groups. Hemodynamic parameters were significantly higher at 3 and 5 min in Group M. Postoperative sore throat was recorded in 12/30 (40%) in Group M compared to 3/30 (10%) in groups C and D each ( P value 0.037). CONCLUSION: C-MAC ® VL requires less time for intubation, provides better glottic view, and has higher success, with better attenuation of hemodynamic response and fewer complications compared to ML.
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