Loganathan V, Thirunavukkarasu P, Muthukrishnan V
… +1 more, Dhanuskodi T
Natl Med J India
· 2024 · PMID 40257165
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Background We aimed to assess the food safety and hygiene practices at street food vending units (SFVUs) in urban and semi-urban areas of Puducherry. Methods We did an observational assessment in two areas of Puducherry....Background We aimed to assess the food safety and hygiene practices at street food vending units (SFVUs) in urban and semi-urban areas of Puducherry. Methods We did an observational assessment in two areas of Puducherry. We did a walk-through mapping and enumeration to identify active SFVUs. Later, through discrete non-participatory observations, we recorded various physical, environmental, food handling, vending and behavioural aspects involved in street food vending using a checklist. This was done at an optimal distance from the SFVUs, without the knowledge of the vendor. Results Of the 115 SFVUs enumerated, 102 units were active during observation visits; 52 in Lawspet (urban) and 50 in Villianur (semi-urban). None of these units displayed the licence or certification required under India's Food Safety and Standards Act. Only 29 (28.3%) of the units had dedicated handwashing facilities, and 50 (49%) had dustbins. All the units had separated raw foods from cooked foods. Other key characteristics such as maintenance of appropriate temperature to preserve foods, appropriate packaging materials, and cleaning methods, were less than satisfactory. Vendors involved in frequent unhygienic behaviours and practices, including frequent contact with food being served, body parts, cash and utensils, but in relatively fewer healthy behaviours such as handwashing or cleaning. Conclusion Street food vending and consumption were common and of unsatisfactory standards in urban and semi-urban parts of Puducherry.
Ajan A, VON Lieres JS, Jayan V
… +4 more, M SB, Sasi DD, Mohandas R, Rao BR
Natl Med J India
· 2024 · PMID 40257163
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Background There is a need for affordable and effective air-filtering respirators, that provide the user protection against infection and are comfortable to wear. Among the various air-filtering respirators, powered air-...Background There is a need for affordable and effective air-filtering respirators, that provide the user protection against infection and are comfortable to wear. Among the various air-filtering respirators, powered air-purifying respirators (PAPR) that supply the user with filtered air through a powered system provide better protection than the commonly used N-95 masks, that directly filters the air that surrounds the user, with filtration efficiency of these procedures being up to 99.99% and up to 95%, respectively. However, in India, the PAPRs are imported, making them unaffordable. Engineers at our university developed a low-cost PAPR model. We investigated the feasibility of using this low-cost PAPR as a potential air-filtering respirator as part of personal protective equipment. Methods In a simulation study, 20 woman nurses wore an N-95 mask with face shield, or the low-cost PAPR in two separate sessions and performed routine nursing tasks. They then answered questionnaires to assess their perceived comfort and suitability for the tasks. Results The low-cost PAPR provided better breathing comfort and vision. However, the current N-95 mask system was perceived to be more suitable for tasks requiring high mobility. Discussion Our study demonstrated the feasibility of the low-cost PAPR model, particularly for low-mobility tasks.
Natl Med J India
· 2024 · PMID 40257162
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Background Healthcare professionals require continuous professional development and training to improve their knowledge and skills to prevent or minimize errors in blood transfusion. The novel Coronavirus-19 (Covid-19) p...Background Healthcare professionals require continuous professional development and training to improve their knowledge and skills to prevent or minimize errors in blood transfusion. The novel Coronavirus-19 (Covid-19) pandemic affected face-to-face medical education and resulted in a shift from traditional education methods to online or virtual methods. We analysed the effect of virtual blood safety training on participant's knowledge and perception. Methods A prospective analysis of pre-test and post-test responses to a 25-item multiple choice questionnaire and feedback received for the training programme were analysed. The training feedback was obtained using a Google form link. Results The mean pre-test score of 131 analyzed participants was 16.02, which increased to 18.06 after the training. The difference was not statistically significant. The mean pre-test and post-test scores for doctors (n=45) were 17.91 and 19.33, respectively which was statistically significant. There was no statistically significant difference between the mean pre-test (15.03) and post-test (17.39) scores of technical staff (n=86). The majority (54%) preferred in-person physical training during feedback. Conclusion Virtual training can be conducted as a temporary measure. We did not find a difference in participants' knowledge except for doctors. The majority of participants preferred in-person training.
Natl Med J India
· 2024 · PMID 40257161
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Myeloproliferative neoplasms (MPNs) can be classified into two major categories, namely chronic myeloid leukaemia (CML) and Philadelphia-negative MPNs (PN-MPNs). BCR- ABL1 reassortment is an irreplaceable indicator for t...Myeloproliferative neoplasms (MPNs) can be classified into two major categories, namely chronic myeloid leukaemia (CML) and Philadelphia-negative MPNs (PN-MPNs). BCR- ABL1 reassortment is an irreplaceable indicator for the diagnosis of typical CML, while the V617F mutation on the Janus kinase 2 (JAK2) gene is common in PN-MPNs patients. Generally, these two genetic abnormalities are considered unable to coexist. We report a patient with CML who had both genetic changes, suggesting that when tyrosine kinase inhibitors (TKIs) monotherapy cannot obtain satisfactory treatment outcomes in CML patients, another possibility besides disease progression is a mutation on the JAK2 V617F gene.
Marwah V, Hegde A, Adhikari S
… +1 more, Choudhary R
Natl Med J India
· 2024 · PMID 40257160
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Antiphospholipid antibody syndrome (APS) is characterized by vascular thrombosis. Somewhat paradoxically, some patients with this disease develop diffuse alveolar haemorrhage. This bleeding is usually a delayed manifesta...Antiphospholipid antibody syndrome (APS) is characterized by vascular thrombosis. Somewhat paradoxically, some patients with this disease develop diffuse alveolar haemorrhage. This bleeding is usually a delayed manifestation, occurring a few years after the onset of other manifestations and diagnosis of APS. We encountered a patient with an unusual presentation, i.e. onset with diffuse alveolar haemorrhage as well as vascular thromboses. He also had autoimmune haemolytic anaemia, which is infrequent in APS. The diagnosis of APS was based on elevated levels of IgM and IgG anti-cardiolipin antibody and IgG and IgM beta-2 GP1 antibodies. Treatment with high-dose glucocorticoids, anticoagulants and rituximab led to a decline in levels of these antibodies and was associated with a good and lasting clinical response.
Khokhar S, Rani D, Namdev V
… +2 more, Rathod A, Kumar S
Natl Med J India
· 2024 · PMID 40257159
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Alagille syndrome is a multisystem disorder inherited in an autosomal dominant manner with a variable phenotypic presentation. Typical features include intrahepatic bile duct paucity, butterfly-shaped vertebrae, typical...Alagille syndrome is a multisystem disorder inherited in an autosomal dominant manner with a variable phenotypic presentation. Typical features include intrahepatic bile duct paucity, butterfly-shaped vertebrae, typical facies, axenfeld anomaly (posterior embryotoxon) and cardiac abnormalities. Since this syndrome has typical ocular associations, ophthalmologists also have an important role in diagnosing the condition. Ocular features include posterior embryotoxon, corneal pannus, chorioretinal abnormalities and posterior subcapsular cataract. We report a toddler, diagnosed with Alagille syndrome who presented to us with a visually significant lamellar cataract in both eyes. To the best of our knowledge, this is the first case reporting lamellar cataract in a toddler with Alagille syndrome.
Yadav R, Goyal M, Aggarwal A
… +1 more, Kulshreshtha B
Natl Med J India
· 2024 · PMID 40257157
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Resistance to thyroid hormone (RTH) is rare and is characterized by high circulating levels of thyroid hormones in the presence of either normal or elevated thyroid stimulating hormone (TSH) levels. Decreased responsiven...Resistance to thyroid hormone (RTH) is rare and is characterized by high circulating levels of thyroid hormones in the presence of either normal or elevated thyroid stimulating hormone (TSH) levels. Decreased responsiveness of the peripheral tissues to thyroid hormones owing to defective thyroid receptor function is the underlying cause. RTH is variable in its presentation. We report a 21-year-old man with long-standing attention deficit hyperactivity disorder (ADHD) and learning disabilities. His thyroid function tests showed an increased free T3 and T4 in the presence of a non-suppressed TSH. Other pituitary hormones were normal. Subsequently, a genetic analysis revealed a heterozygous mutation (Pro452Thr) in THRβ gene, establishing the diagnosis of RTH. Thus, this was a RTH presenting as ADHD due to a novel mutation in the thyroid hormone receptor gene.
Natl Med J India
· 2024 · PMID 40257155
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Background Medical research, even though, an integral part of medical education, remains the most neglected domain in the medical curriculum in most medical colleges across India. Research, when introduced in the medical...Background Medical research, even though, an integral part of medical education, remains the most neglected domain in the medical curriculum in most medical colleges across India. Research, when introduced in the medical curriculum, gives an early opportunity to medical students to participate in it. We did a study to gain an insight into the perceptions of medical students and explored barriers and enablers towards uptake of research activities. Methods A mixed methods study was done over 9 months using a pre-tested semi-structured questionnaire and a focus group discussion among medical students. First, a quantitative survey was done using Google forms to assess students perception and attitude towards research. This was followed by 2 focused group discussions to explore the barriers and enablers towards uptake of research activities. Descriptive analysis was done for quantitative data and manual thematic content analysis for qualitative data. Results A total of 350 participants responded to the survey out of which 168 (59.1%) were women. Most students (339; 96.9%) perceived research to be important. Also, 313 (89.4%) and 245 (70%) showed willingness to attend research methodology workshops and conduct research studies, respectively. A manual thematic content analysis of the focus group discussion revealed two main themes: (i) barriers to conduct of research and (ii) enablers towards uptake of research. The major barriers were lack of knowledge about conducting research and lack of time and financial constraints. The enablers were conduct of periodic research methodology workshops and adequate mentoring by faculty. Conclusion There is a gap in the existing knowledge and practice in undergraduate medical research. Our study ascertained potential barriers as well as enablers for enhancing research activities by medical students. Adequate institutional support including funding for research coupled with proper mentoring by faculty and family support is crucial to foster a positive research culture among undergraduate medical students.