Medicine and Health Sciences Commons^™

An Internal Audit On Patient Safety And Quality Of Services In A Rural Health Training Center, Coimbatore., Josphine Priscilla Charles, Kathiravan Rajendran, Jenit Osborn

Digital Journal of Clinical Medicine

Prioritizing patient safety is imperative for enhancing quality healthcare, especially in lower- and middle-income countries. Recognizing this urgency, India's Ministry of Health and Family Welfare introduced the 'SaQushal' toolkit, empowering health facilities to self-assess and improve their safety practices. This study presents an internal audit at a Rural Health Training Centre (RHTC) in Coimbatore, India, utilizing the 'SaQushal' framework. The facility achieved an overall score of 63%, exceeding the 50% minimum threshold for each domain, indicating commendable efforts towards establishing good quality standards. Notably, all domains scored above 50%, highlighting strengths across various safety dimensions. While acknowledging this progress, the …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Scope And Limitations Of Chatgpt In Research And Academic Writing, Shyam Pyare Singh, Imran Ahmed Khan, Shaila Kumari Mitra

Digital Journal of Clinical Medicine

Background: ChatGPT has proven to be an invaluable tool, enabling human-like interactions, and facilitating knowledge exchange. It possesses the ability to generate coherent and contextually relevant responses based on the input it receives. In essence, ChatGPT responds to anything in a conversational manner and provides an output that looks like human writing. However, with the rapid advancement of medical research, there is an increasing concern that ChatGPT may be abused to create articles devoid of clinical reasoning and critical thinking.

METHODS: A through literature search was conducted on PubMed and Google scholar to find relevant article according to objective.

RESULTS: …

Importance Of Geriatrics In Psychiatric Postgraduate Education, Dr Anand R, Dr Kishor M, Dr Murali M R

Digital Journal of Clinical Medicine

Introduction

To assess the importance of Geriatrics in Psychiatric postgraduate education

Methodology

Marks allotted in question papers from Geriatrics in Psychiatry postgraduate examination from a university for a 5-year period was evaluated.

Discussion

1-6% of entire theory evaluation was related to Geriatric mental health topics predominantly on dementia and related disorders.

Psychiatric Morbidity And Dental Problems Among Women From Institutional Care, Meghana Hanchate, Kishor M, Ashwini T S

Digital Journal of Clinical Medicine

No abstract provided.

Neuroimaging Manifestatations In Covid-19 And Its Sequelae, Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel pathogenic virus in late 2019, infecting millions of people with severe pulmonary infections. It spread worldwide in a short time and became a pandemic, after which the World Health Organization (WHO) declared it a public health emergency. Central nervous system involvement by COVID-19 is already an established entity in the literature. The aim of this study was to evaluate in detail the acute and delayed neurological manifestations of COVID -19.

RESULTS: COVID-19 infection can cause various neurologic manifestations and imaging findings. The most common neuroradiological abnormality is cerebrovascular …

Effectiveness Of Amiodarone, Propafenone And Synchronized Electrical Cardioversion For Conversion Of Atrial Fibrillation Paroxysm To Sinus Rhythm In Rigas Stradins University Hospital Department Of Emergency Medicine., Mihails Tracevskis

Digital Journal of Clinical Medicine

Abstract

Introduction: Atrial fibrillation remains a pervasive global health concern, contributing significantly to the incidence of stroke, heart failure, sudden death, and overall cardiovascular morbidity.

Materials and methods: The present study undertook a retrospective analysis involving a meticulous examination of 127 patients, representing a diverse cohort of individuals encompassing 73 men (with a median age of 62 and a range of 37-75) and 54 women (with a median age of 60 and a range of 42-78) duration of atrial fibrillation 48 hours or less.

Results: The results highlighted amiodarone's remarkable efficiency, as it successfully converted 81.2% of cases (56 …

A Review On Anatomical And Surgical Importance Of Mammary Gland, Sneha Jm Sneha Jm Dr, Pushpa Nb Dr, Vidya Cs Dr, Manjappa M Dr

Digital Journal of Clinical Medicine

ABSTRACT

The mammary gland is an exocrine gland present in female mammals responsible for the production and secretion of milk during the process of lactation. It is mainly composed by epithelial cells and adipocytes. The features that make mammary gland unique are 1) its highly plastic properties displayed during pregnancy, lactation and involution (all steps belonging to the lactation cycle) and 2) its requirement to grow in close association with adipocytes which are absolutely necessary to ensure mammary gland development at puberty and remodelling during the lactation cycle. (Georgia colleluori, Jessica perugini, Giorgio barbatelli, and saverio cintr (2021).

Conclusion

The …

Unilateral Agenesis Of Adnexa, Srinidhi Govindarajan, Poornima M Associate Professor, Rashmi H.S., Aishwarya Bhat

Digital Journal of Clinical Medicine

No abstract provided.

Association Of Physical Activity And Screen Time Usage Of Adolescents In Rural Areas Of Mysore., Aakash Pavan Kumar, Nayanabai Shabadi, Bikram Sinha Roy, Anchu R. Nath, Arun Gopi

Digital Journal of Clinical Medicine

Introduction:

In these changing times there have been increased usage of screen device due to more accessibility to both device and the internet and a greater number of children are having reduced physical activity. The purpose of the current study was to determine if screen usage among adolescents (11-17yrs) who live in supportive environments is associated with decreased levels of moderate to vigorous physical activity.

Methods & materials:

A school-based cross-sectional study was conducted in two rural schools of Mysore, Karnataka in February 2023, in 176 students between the age group of 11 – 17yrs. Physical activity and screen …

A Case Of Galeazzi Fracture Subluxation Of Left Forearm In Paediatric Age Group, Sauparna Dey

Digital Journal of Clinical Medicine

A case report of a rare form of fracture- Galeazzi fracture subluxation in paediatric age group. Showing post operative progress of the patient, with a discussion on possible methodology of approaching such fractures. Correct management of the fracture is essential for proper healing and avoiding complications.

A Case Of Obstructed Left Diaphragmatic Hernia, Shikha Agarwal Dr.

Digital Journal of Clinical Medicine

Diaphragmatic hernia is protrusion of abdominal viscera into the chest cavity. Most commonly seen due to congenital defects in the diaphragm, hence causing herniation of abdominal contents including stomach, bowel, pancreas, omentum. Acquired diaphragmatic hernia can be secondary to injury to diaphragm. Patient presents with respiratory distress, due to reduced lung expansion. Early correlation with radiological scans is required for appropriate timely management, to prevent further deterioration of condition.

Stroke: A Neurological Complication In Covid-19., Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

No abstract provided.

A Study On The Prevalence Of Vitamin B12 Deficiency In Eastern Indian Type 2 Diabetes Mellitus Patients With Peripheral Neuropathy On Metformin Presenting To A Tertiary Care Hospital, Ajay Hanumanthu, Soumik Goswami, Kavya Bhadrapura Thimmegowda, Nilanjan Sengupta, Arjun Baidya, Pranab Kumar Sahana

Digital Journal of Clinical Medicine

Introduction:

The association between long-term metformin use in type 2 diabetes mellitus (T2DM) and low vitamin B12 levels has been proven and screening for the same is recommended by American Diabetes Association (ADA) guidelines. The potential of the deficiency to cause or worsen diabetic peripheral neuropathy (DPN) in T2DM patients has been investigated in previous studies. However, the prevalence estimates of vitamin B12 deficiency in T2DM patients treated with long term metformin and having established DPN is lacking in our country. The aim of our study was to estimate the prevalence of vitamin B12 deficiency in T2DM patients with DPN …

Mgso4 For Neuroprophylaxis In Preterm Birth – Clinical Audit- Re Audit, Dr Anupama Marnal B A Sr, Poornima M Associate Professor, Suma K B Professor, Sahana K Assistant Professor

Digital Journal of Clinical Medicine

No abstract provided.

The Trichobezoar Enigma: Untangling The Intricacies Of Rapunzel Syndrome, Debabrata Sahu, Dr Rajkishor Sahu

Digital Journal of Clinical Medicine

Rapunzel Syndrome is a rare manifestation of trichobezoar, characterized by the presence of hair strands extending beyond the stomach and into the duodenum. Trichobezoars typically develop in individuals with a history of trichotillomania, a compulsive behavioral disorder involving hair-pulling, combined with trichophagia, the ingestion of hair. While trichobezoars predominantly form within the stomach, their occurrence in the jejunum is infrequent. This condition is more commonly observed in adolescent females.

The formation of bezoars within the gastrointestinal tract is typically attributed to anatomical changes. However, in cases where no such anatomical abnormalities are present, psychiatric disorders like trichotillomania can lead to …

Modified Electroconvulsive Therapy As Maintenance Treatment, Jatin Kumar, Kishor M, Murali M R

Digital Journal of Clinical Medicine

Depression is the most common psychiatric condition that significantly affects the quality of life of individual affected with it and it can present with various signs and symptoms. It usually presents with persistent and pervasive sadness of mood, anhedonia, sleep disturbance, reduced appetite, reduced concentration, multiple somatic symptoms, and suicidal thoughts. In this case report a 61-year-old gentleman presented with sadness of mood, loss of interest, sleep disturbance, multiple body aches, and abdominal pain which varied from 2 to 6 weeks. He had failed to respond to multiple classes of antidepressants, mood stabilizers, and antipsychotics. However, he would respond well …

Case Series; Imaging In Lesser-Known Ailments Of The Pituitary Gland And Sellar Region, Harisha H L, Kavya Bhadrapura Thimmegowda, Ajay Hanumanthu, Vikram Patil Dr, Gurumurthy B, Dr Abhijith Roys

Digital Journal of Clinical Medicine

No abstract provided.

Mpd, Dr.Amara Charitha Duggirala, Dr.Savitha Vijayakumar, Dr . Shashidhara K C, Dr.Jerin Joseph

Digital Journal of Clinical Medicine

No abstract provided.

Beyond Breathless: Unravelling The Enigma Of Pulmonary Arteriovenous Malformations, Sri Mounya Jampala, Jagadish Kumar K Dr., Manjunath V G, Nandish H R

Digital Journal of Clinical Medicine

Pulmonary Arteriovenous Malformations (AVMs) are abnormal connections between the pulmonary arteries and veins, leading to a direct shunting of blood without passing through the normal capillary bed. These AVMs can be associated with a rare genetic disorder called Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome. HHT is an autosomal dominant disorder characterized by the development of fragile telangiectasias in various organs, including the skin and mucous membranes. These telangiectasias are prone to bleeding, leading to recurrent nosebleeds and mucocutaneous bleeding. In patients with HHT, the most common site of AVMs is in the lungs. Pulmonary AVMs can cause …

Rational Use Of Blood And Blood Components In A Tertiary Care Hospital: A Crossectional Study., Rupali Chordia Dr, Dr Himani Shemar Dr

Digital Journal of Clinical Medicine

Abstract:

Introduction: Blood transfusion is a life saving process and a complex phenomenon. Judicial use of blood and its components is the need of the hour. Objectives: The present study was planned with the objective to assess the appropriateness of blood transfusions in patients admitted in the hospital as per WHO guidelines. Materials and Methods: A crossectional study was conducted at tertiary care hospital for a period of one and a half years. Records of patients from blood bank were evaluated to collect data. MS Excel was used to enter the data and IBM SPSS Statistics for Windows …

Cerebral Venous Thrombosis In Pregnancy : A Case Report, Dr Sumuk M S Sr, Dr Anupama Marnal B A Sr, Dr Mamatha S Professor And Head Of The Department, Poornima M Associate Professor

Digital Journal of Clinical Medicine

Cerebral venous thrombosis (CVT) is a rare complication encountered in pregnancy. Symptoms of CVT include headache, limb paresis, seizures , disturbed consciousness , visual disturbances. We present our 25 years old pregnant patient who presented with unsteadiness of gait , weakness and numbness of all four limbs, vomiting headache , giddiness due to which it was difficult for her to perform her daily activities. After the differential diagnostic examinations, we recognised cerebral venous thrombosis. After anti-coagulant treatment , the symptoms resolved. We would like to convey that such symptoms in pregnant women we should always think of CVT.

Redefining The Role Of Asha Workers In Indian Healthcare, Sufiya Mohsin, Satish Kumar Gupta, Imran Ahmed Khan, Anish Kumar Gupta

Digital Journal of Clinical Medicine

Community health professionals are critical in filling the gap between traditional healthcare systems and marginalized populations. Accredited Social Health Activists (ASHA) workers have been an important workforce in providing essential healthcare services to rural and marginalized communities. ASHA workers have emerged as a cornerstone of India's healthcare system, playing a pivotal role in bridging the gap between rural and marginalized communities and formal healthcare services. There is a need for expansion of the working of ASHAs to utilize them more efficiently. Through enhanced training, technological integration, and policy support, ASHA workers can transform into empowered agents of change, ensuring equitable …

Effect Of Relaxation Intervention On Stress Levels And Cognitive Skills In Professional Students, Sandhra Sabu, Ravikiran Kisan, . Swapnali

Digital Journal of Clinical Medicine

Background: Medical Professional training is likely to encounter a variety of hassles and stress in relation to the developmental tasks associated with transition from school life to professional college life. The vast syllabus, peer competition for academic performance, continuous evaluation, and long duration of the training makes medical education stressful. Many students feel a need to relieve stress and it is a necessity to equip students with proven techniques to reduce stress and cope up with the situation. Proper cognitive functioning has been found to be an important factor for academic performance.

Methods: The present study is a cross …

Relationship Between Femoral Artery Intima-Media Thickness And Atherosclerosis In Patients With Chronic Kidney Disease- A One Year Hospital-Based Cross-Sectional Study, Dr. Somashekhar Sogi, Dr. Ravi Sarvi, Dr. Pradeep Goudar, Dr. Mallikarjun Karishetti, Dr.V.V Hattiholi, Dr.Meenakshi Sarvi

Digital Journal of Clinical Medicine

Introduction: Chronic kidney disease (CKD) is one of the leading causes of morbidity and mortality worldwide. CKD and Peripheral arterial disease both independently increase the risk for cardiovascular disease (CVD) events and contribute significantly to morbidity and mortality. There is limited data about the co-relation between ultrasound measures of the femoral artery in peripheral vascular disease (PVD) & renal functional status. This research hence will help us in the establishment of a relationship between femoral intima-media thickness (fIMT) with CKD. Also, IMT assessment might help in earlier detection of atherosclerotic plaques & hence PVD.

Materials and methods: A cross sectional …

A Case Of Inferior Dislocation Of Right Shoulder, Gauri A. Nair

Digital Journal of Clinical Medicine

Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form. It appears in less than 0.5% of all shoulder dislocations. Patient characteristically presents with an arm locked in upright position - Luxatio erecta. Its etiology, clinical presentation and radiographic findings are distinct. An awareness of associated potential neurovascular injuries and rotator cuff tears is important in this rare entity and should be excluded with high index of suspicion. Preferred modality of treatment depends upon the age of the patient and the extent of neurovascular involvement. …

Personality Disorder Predisposing To Alcohol Dependence, Samarchitha S Ms., Venkatesh Babu Dr., Megha Sadashiv Dr., Sudeep Pk Mr.

Digital Journal of Clinical Medicine

No abstract provided.

High-Velocity Fracture: Case Of Displaced Intertrochanteric Fracture Offemur With Spiral Fracture Of Shaft Of Right Femur, Gayathri Sureshkumar Nair

Digital Journal of Clinical Medicine

BACKGROUND

Intertrochanteric fracture is a common orthopedic condition characterized by extracapsular fractures of the proximal femur that occur between the greater and lesser trochanter with predominance in elderly population, especially those with osteoporosis, wherein even a low energy mechanism is enough to cause the fracture.

There is an observed female predominance with ratio between 2:1 and 8:1. [1,2]

Commonly observed symptoms include shortened and externally rotated limb, pain and bony tenderness around the hip joint, inability to bear weight on the affected limb to name a few.

Management depends upon age of patient, nature of the fracture, number of comminuted …

Comparison Of Conventional Pap Smear And Manual Liquid Based Cytology With P16 Marker In Screening For Cervical Cancer In Indian Tertiary Healthcare Setups In Mysuru, Gayathri Sureshkumar Nair, Nandini Manoli, Nandish Manoli

Digital Journal of Clinical Medicine

In India, there are 20.2 per 100000 new cases of Cervical Cancer diagnosed and 11.1 per 100000 deaths annually accounting for more than one fifths of global cervical cancer deaths. [1] Thus, due to an absence of a national immunization program to cover human papillomavirus (HPV) vaccination and lack of accessible cervical cancer screening, the disease is characterized by late detection, lack of access to affordable and quality health care, and high mortality rates. [2]

Papanicolaou Smear Test was a novel invention by Dr George Papanicolaou in the year 1927 which gained maximum popularity in 1950 as a screening test …

Post Covid-19 Cognitive Impairment In A Patient With Bipolar Disorder, Nilanjana Dutta, Raghav Gupta, Dr. M Kishor Mbbs, Md

Digital Journal of Clinical Medicine

COVID-19 has caused widespread health conditions, psychological and social distress among people and there is evidence that shows profound neuropsychiatric complications during acute and post-recovery phases of the infection. Cognitive impairment occurring after COVID-19 infection can be explained by various mechanisms, including persistent systemic inflammation, direct viral invasion, alteration in the blood-brain barrier, and cerebrovascular endothelial injury.There are few studies that have explored the impact of COVID-19 on pre-existing psychiatric conditions. This case report highlights the temporal association of cognitive impairment with COVID-19 and the need for cognitive assessment and management in post-COVID-19 patients with pre-existing psychiatric conditions.