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   Table of Contents - Current issue
January-February 2023
Volume 13 | Issue 1
Page Nos. 1-46

Online since Friday, February 24, 2023

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Emerging and newer diseases in India: A perspective p. 1
Atul Kakar, Karun Saathveeg Sam, Sumanyu Kakar
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Intraperitoneal onlay mesh versus laparoscopy-assisted ventral hernia patch mesh repair in small primary ventral hernias: A randomised control trial p. 4
Harish Kanuri, Ashish Dey, Tarun Mittal, Shikhar Tripathi, Vinod K Malik
Aims: The aim of this study is to compare and evaluate short-term outcomes of laparoscopy-assisted composite patch mesh repair versus laparoscopic intraperitoneal onlay mesh in small primary midline ventral hernias. Materials and Methods: Eighty consecutive patients with small (<2 cm) midline ventral hernia admitted to the Department of General and Laparoscopic surgery at Sir Ganga Ram Hospital, New Delhi, from January 2017 to May 2019 were included in the study and randomised into two groups. Group A included patients who underwent laparoscopic intraperitoneal onlay mesh repair with the classical barrier flat mesh and Group B patients underwent laparoscopy-assisted ventral hernia patch-mesh repair. Parameters assessed at the follow-up were early post-operative pain by Visual Analogue Scale score, wound complications, early recurrence and hospital stay. Results: Early post-operative pain was more in the laparoscopic intraperitoneal onlay mesh group and the difference was statistically significant. Usage of additional analgesia in the post-operative period was required only in the laparoscopic intraperitoneal onlay mesh group. There was a statistically significant difference between the two groups in terms of hospital stay. Conclusion: For primary midline ventral hernia, with defect size <2 cm, laparoscopy-assisted composite patch mesh repair is feasible and safe. It causes less pain and necessitates less usage of additional analgesia enabling patients to be discharged earlier.
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The risk of abuse and mental health status of elderly residing in urban communities of Delhi p. 10
Sumity Arora, Raminder Kalra
Background and Objectives: Elderly is a vital part of the population of any country who owe respect and attention equally to any other section of the population. The present study was aimed at assessing the risk of abuse amongst the elderly, mental health status of elderly and correlation of abuse with their mental health of the elderly residing in urban communities of Delhi. Materials and Methods: This study was cross-sectional and descriptive conducted on 270 elderly chosen by cluster sampling method residing in the urban community of South Delhi, India. Sociodemographic data, elder abuse and their mental health were assessed by sociodemographic tool, Hwalek-Sengstock Elder Abuse Screening Test and Self Reporting Questionnaire (SRQ-20), respectively. Results: Online Social Science Statistics package was used for analysis of the study. In the present study, majority of the participants were male and were in the age of 61–70 years. Approximately 50% of elderly were uneducated and not working. The majority (63%) of the elderly reported a mild risk of abuse. The majority of the participants reported altered mental health, i.e., SRQ >7. In the study findings, elder abuse and mental health were significantly associated (at P < 0.05) with each other. Conclusion: The study showed that elder abuse and mental well-being of elderly are related to each other and it requires appropriate involvement of concerned authority to protect elderly living in the community of Delhi, India.
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Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting p. 15
Panneerselvam Periasamy, Suganthi Vajiravelu, Sasikala Gunasekaran
Background: Understanding medical students' mental health using subjective well-being indicators is important because it will allow for the creation of positive psychology-based intervention techniques as well as the implementation of main and secondary psychiatric disorder prevention procedures for medical students. These indicators may help to improve the overall quality of health care provided by these future professionals to the general public. Aims: The aim of the present study was to assess the levels of stress and subjective well being as well as factors related to it and their link to the academic performance amongst medical students of a tertiary care setting. Materials and Methods: This is a 3-month cross-sectional survey that took place amongst medical students at a tertiary care medical college in Salem, India, between January and March 2022. Students from all academic years, from first year to internship, were included in this study. The study included all students who were willing to participate and gave their informed consent. Results: Of the total 492 respondents, 288 (58.5%) were females and 204 (41.5%) were males. 29.7% of the study participants belonged to the first year of the MBBS course. 43.9% of the study participants possess a very good academic performance and majority (86.6%) of the students have regular attendance towards classes. Conclusion: Taken together, the findings of studies like these could inform preventive interventions aimed at reducing medical students' distress and promoting future doctors' well-being.
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Knowledge of health-care professionals on tobacco cessation and its related activities p. 18
Neetu Kataria, Sandhya Gupta
Background: The tobacco epidemic is one of the biggest public health threats the world has ever faced. There are more than 4000 chemicals in tobacco smoke, of which at least 300 are known to be harmful. A 2015 survey in Italy revealed that 58% of cardiologists correctly indicated smoking as an addiction and 45% regularly advised their patients to stop smoking. Aims: The aim is to assess the knowledge of health care professionals (HCPs) related to tobacco cessation and its related activities. Materials and Methods: A descriptive, cross-sectional, pilot survey on HCPs-30 doctors and 30 nurses was chosen by convenient sampling at a selected tertiary care hospital in New Delhi. Tool: A semi-structured questionnaire contains items to assess knowledge of HCPs regarding tobacco cessation and its activities. Results: 96.3% of doctors and 76% of nurses were 'asked' their patients about their history of tobacco use, respectively. 86.7% of doctors and 70.1% of nurses 'advice' patients to stop tobacco use. 63.3% of doctors and 54.1% of nurses were interested in participating in tobacco cessation training. Conclusion: Most of the HCPs had given brief interventions by 5 'A's method. More tobacco cessation training would be suggested by health-care workers.
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Telemedicine: Zero Contagion risk and enabler of healthcare fire sales p. 26
Neha Ghildiyal, Monika Bangari
India has made remarkable progress in ease of doing business, competitiveness and technological innovation in the past few years. During the COVID-19 pandemic, telemedicine entered the healthcare sector as a boon. Telehealth witnessed accelerated adoption during the COVID-19 pandemic, finding its niche amongst the emerging digitally enabled India. Medical centres are responding to the needy through the use of digital tools and technology, such as telemedicine and virtual care, along with various other virtual means. This research paper discusses the application of the Internet and other related technologies in the health sector for improving access to and efficiency, efficacy and quality of clinical and corporate processes used by healthcare organisations, physicians, patients and consumers to improve the health status of patients. The use of telemedicine during the pandemic has experienced rapid growth. This study essentially focuses on the importance of telemedicine during such trying times. The literature review was performed to study the importance, advantages and disadvantages of telemedicine in India during the pandemic. In addition, research articles, and databases, including Google Scholar, PubMed and Ovid MEDLINE, were searched to study the changes that are rapidly entering the healthcare sector and the efficacy of the concept of telemedicine for patients.
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Legal issues in end-of-life care: Current status in India and the road ahead p. 32
Anjali Gera, Bimla Sharma, Jayashree Sood
End-of-life (EOL) care is a multidisciplinary approach to provide 'whole person care' to individuals with advanced, progressive, incurable or life-limiting illnesses to prevent or relieve suffering with a goal to reduce suffering as much as possible while respecting the patient's wishes. The focus is on comfort, symptom control and quality of death (QOD) rather than actual treatment or prolonging life. It includes withholding or withdrawing life support treatments and initiating palliative care in terminally ill patients. However, lack of awareness amongst people and healthcare workers and inadequate legal framework are barriers to ensuring good QOD. All these issues result in a prolonged stay of terminally ill patients in intensive care units, high financial costs and emotional stress to the family, resulting in an excessive burden on the healthcare system. EOL care poses numerous legal and ethical problems for physicians. It is critical in therapeutic decision-making to protect the rights, dignity and vigour of all individuals concerned, including the patient's family members and the society. Physicians must comprehend the concepts of relevant legal and biomedical ethics to solve EOL care issues.
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Congenital cardiac surgery in a patient with cold agglutinins p. 40
Mridul Agarwal, Reena Khantwal Joshi, Neeraj Aggarwal, Raja Joshi
Cold agglutinin disease is a type of autoimmune haemolytic anaemia caused by autoantibodies that bind to red blood cell antigens at a cold temperature and causes extravascular haemolysis and sometimes thrombosis also. Due to exposure to a lower temperature during open-heart surgery, the activation of haemolysis may occur in the presence of cold agglutinin antibodies. We present the management of a cyanotic child who has undergone open-heart surgery after the detection of high cold agglutinin titres during routine pre-transfusion screening.
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A clinical case report on intraventricular metastatic from a lung primary p. 43
Arnabjyoti Deva Sarma, Moitrayee Devi, Jibon Sharma
Intraventricular metastasis is very often carries a poor outcome. Here may be the case of a 55-year-old farmer presented to us with headache, vomiting and gradual deterioration in vision. Imaging studies revealed a heterogeneously enhancing lesion within the ventricle. Intraoperatively, highly vascular intraventricular lesion arising from Plexus Choroideus was found. Histopathology revealed metastatic lesion from epithelial metastasis. High-resolution computed tomography of the lung revealed a little lesion within the left apex of the lung. The patient recovered well and was referred for radiotherapy.
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Pre-operative evaluation in geriatric patients – Demography does matter p. 45
Harish Gupta
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