Medical Education Commons^™

A Real World Study Of Adherence To Insulin In Diabetic Humans-Stadium Study, Dipsanker Chatterjee, Subham Das

Digital Journal of Clinical Medicine

Background:

With an ever-increasing prevalence of diabetes, lack of adherence to insulin treatment in even a small percentage of patients is a major issue and can lead to significant burden on the healthcare system. This survey analysis seeks to investigate the insulin adherence patterns to identify the factors associated with medication adherence.

Methodology:

The current cross-sectional survey was conducted among diabetes patients on insulin treatment. A list of questions about insulin adherence was provided to the participants in the study and the responses were recorded. The data was analysed using Graph Pad Prism.

Results:

Around 23.2 and 18.6 % of …

Internet Addiction: A Growing Threat: A Cross-Sectional Among The Undergraduate Medical Students Of Tertiary Care Hospital, Mysuru, Rakesh M, Diksha Goswami, Sunil Kumar D, Shwethashree M

Digital Journal of Clinical Medicine

Background: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru.

Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1^st to November 30^th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the …

Placenta Accreta Spectrum Disorder As First Trimester Pregnancy Termination Complication; Case Series, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Placenta Accreta Spectrum (PAS) disorder is rare (2% according to ACOG) condition of pregnancy when the placenta grows deeply into myometrium. This leads to failure of placenta to separate normally from myometrium after delivery and leads to massive hemorrhage. The PAS is classified as PA (Placenta Accreta), PI (Placenta Increta) and PP ( Placenta Percreta), on basis of depth of trophoblastic invasion. Increase in no. of cesarean sections, increasing the incidence of PAS. Cesarean scar on uterus promotes placental tissue to invade deeply in subsequent pregnancy. Antenatal scanning and color imaging can detect PAS, at a very early stage. Here …

Gender Equality– A Sustainable Development Goal In Progress At A Medical College And Hospital In South India, Mr. Manoj S M, Kusuma Kasapura Shivashankar, Suma M. Natraj, Praveen Kulkarni

Digital Journal of Clinical Medicine

Background: Gender Equality is one of the most important SDG and attaining it will ensure a peaceful, prosperous and a balanced world with equal opportunities for both women and men. The Indian scenario in the field of women education has changed with mindset of most parents undergoing a paradigm shift and many girls are encouraged to attend schools, colleges and women are allowed to work. Considering the above shift, our study intended to find out if the same was true and SDG-5, Gender Equality was attained or in progress at our medical college and hospital and hence the study.

Methods: …

The Balm Framework Of Clinical Excellence: An Adoptable Model For Sub-Saharan Africa., Taoreed Adegoke Azeez

Digital Journal of Clinical Medicine

Clinical excellence is the ability to provide rigorous, evidence-based, and rewarding care to the right patients. The BALM (brilliance, attitude, leadership, and materials) framework is a novel model for adjudicating clinical excellence. There are a few models and frameworks for evaluating clinical excellence, but each has its flaws and does not consider the peculiarities of economically-challenged regions such as sub-Saharan Africa. Coincidentally, such low-resource areas have an urgent need for a framework to assess clinical excellence because of their low health-related indices. The five-step mode of professional excellence is a well-recognised tool and was the model upon which the BALM …

Alkaptonuria Presenting With Back Pain: A Diagnostic Dilemma, Arnav Salar, Dyuksha Arora, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Alkaptonuria is a rare inborn error of metabolism due to a deficiency of homogentisate 1,2 dioxygenase, resulting in homogentisic acid accumulation in tissues. It is characterised by homogentisic aciduria, ochronosis, and arthritis. We hereby discuss a 46-year-old male who presented with progressive lower back pain and polyarthralgia for ten years, initially diagnosed as ankylosing spondylitis. Characteristic skin pigmentation, ochronosis, and radiological findings led to the correct diagnosis of alkaptonuria. This case highlights the importance of considering alkaptonuria as a differential diagnosis for chronic back pain and arthritis, mainly when sacroiliac joints are spared, and ochronosis is present. While no cure …

Knowledge, Attitudes, And Practices Among Health Care Professionals In A Tertiary Care Teaching Hospital, Mysuru, Rakesh M, Dr Sunil Kumar D, Dr Shwethashree M, Kodeeswaran M, Aradhya M. Gowda

Digital Journal of Clinical Medicine

ABSTRACT

Background: Biomedical waste (BMW) refers to waste generated during the diagnosis, treatment, or immunization of humans or animals, posing risks to health and the environment if not managed properly. Proper knowledge, attitudes, and practices (KAP) among healthcare professionals are essential for effective BMW management. This study assessed the KAP of healthcare workers regarding BMW in a tertiary care teaching hospital.

Methods: A cross-sectional study was conducted among 149 healthcare professionals at a private medical college from April 10 to May 10, 2023. Participants were selected using simple random sampling, including consultants, postgraduates, interns, nursing staff, laboratory technicians, and housekeeping …

The Pros And Cons Of Systematic Review And Meta-Analysis: Methodological Insights And Future Directions, Malik Maaz Ahmad, Imran Ahmed Khan, Harish Chandra Tiwari

Digital Journal of Clinical Medicine

Systematic reviews (SR) and meta-analyses (MA) are the highest level of evidence in the hierarchy of scientific evidence which aggregate data from various studies, offering a comprehensive overview of a particular topic. This approach reduces the influence of isolated studies that may have small sample sizes or unique biases, leading to more robust conclusions. By combining data from multiple studies, the overall sample size is increased enhancing the statistical power and precision of the results. The value of SR and MA is often compromised by the poor quality of the primary studies they include, which can lead to misleading conclusions. …

Exploring The Elective Experience: A Review Of The "Adult Psychiatry" Elective At A Medical College, Dyuksha Arora, Kishor M

Digital Journal of Clinical Medicine

This review delves into the motivations, experiences, and perceived advantages and disadvantages of undertaking the 'Adult Psychiatry' as an elective at JSS Medical College. Experiences from four students, two from the 2019 batch and two from the 2020 batch, provide a comprehensive overview of their elective.

A Rare Case Of Early Onset Vitamin B6 Dependent Epilepsy, Rohit Thorat, Qudsiya Ansari, Kailas Randad, Vinaya Singh, Akash Sarkate

Digital Journal of Clinical Medicine

Pyridoxine dependent epilepsy (PDE) is a rare seizure disorder which manifests in neonatal period, but can be manifested in early infancy also. Seizures are seen in the first month of life in the classical form, but in the atypical form they don't show up until later in life, sometimes as late as three years old. It has an autosomal recessive inheritance caused by mutation in ALDH7A1 gene, causing deficiency of alpha-aminoadepic semialdehyde dehydrogenase commonly known as antiquitin (ATQ). Its deficiency leads to accumulation of metabolites, which causes deficiency of functional form of pyridoxine. The seizures are non-responding to antiepileptic medications, …

Clozapine And Modified Electroconvulsive Therapy (M-Ect) In Treatment Resistant Schizophrenia (Trs) – A Case Report, Kareena Arora, Kishor M, Murali M R, Suhas K Mr

Digital Journal of Clinical Medicine

Schizophrenia is psychiatric disorder affecting less than 1% of population that can be devastating, characterized by positive, negative and cognitive symptoms. This can lead to significant functional impairment. Despite intensive and ongoing research, outcomes from best-practice treatment are often suboptimal. Unfortunately, not all the patients respond to antipsychotic medications. Overall estimates suggest that one-fifth to one-half of patients have treatment resistant schizophrenia (TRS).

TRS include failure sequential trial of two different antipsychotics with sufficient dose, duration and adherence as a minimum criterion. TRS represents major clinical challenge.

Clozapine is the only drug approved for TRS as it is the drug …

Osteochondroma At Unusual Location Causing Deformity (Metacarpal): A Rare Case Report, Pranshu S. Panwar, Prakash M, Purushothama Sastry, Gurumurthy B, Punith N, Ravi H. S

Digital Journal of Clinical Medicine

INTRODUCTION: Osteochondroma is benign tumors of bone which usually occurs in long bones. Common locations proximal tibia, distal femur and proximal humerus. Metacarpals are rarely affected.

Case Report: Patient, 10 years old/boy came to JSS hospital with complaint of swelling and deformity over left hand for 2 years. After relevant clinical examination and radiological investigation, patient was diagnosed with synostoses of 5^th metacarpal with 4^th metacarpal. Patient was taken up deformity correction and intra-op patient was diagnosed as exostoses of 5^th metacarpal. Post-op radiograph was taken. After 1-month ex-fix was removed. After 4 months follow up, deformity …

Internet Gaming Disorders Amongst Medical Undergraduates In Tamil Nadu, India - A Cross Sectional Study, Rejee Sneha Ebanezer, Sumedha K, Murugan V

Digital Journal of Clinical Medicine

Abstract

Background: Internet Gaming Disorder (IGD) or internet-related gaming addictions are characterized by severely impaired control over gaming affecting routine activities, followed by several psychological, physical and social issues. Budding medical undergraduates who are future health professionals might have positive effects on their studies and career goals when saved from internet gaming addictions. Hence, this study aimed to identify the proportion of medical undergraduate students and interns with internet gaming disorders studying in a private medical college and tertiary care hospital.

Setting: A tertiary care Hospital and Medical College, Tamil Nadu, India

Study design: Cross – sectional study.

Participants: Medical …

High Stakes And Hidden Risks: A Case Series On Pathological Gambling In Context With Affective Disorders And Substance Abuse, Avni Gupta, Namita Deka, Mahesh Kumar

Digital Journal of Clinical Medicine

Background: Pathological gambling is a non–substance-related addictive disorder, characterized by persistent preoccupation with gambling, impaired control, and continuation despite negative consequences. It is associated with financial losses, social and occupational dysfunction, and psychiatric comorbidities, including affective and substance use disorders. Although international prevalence estimates range from 1–2%, research in India remains limited, particularly with the rise of online gambling.

Methods: We report a case series of three individuals presenting to a tertiary-care psychiatry outpatient department with pathological gambling. Clinical assessments included detailed psychiatric evaluation, mental status examination, and psychometric assessments using the Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory …

Ada Report: Ada Board Discusses Membership, Looks Ahead To 2024, Michele Tulak-Gorecki Dds

The Journal of the Michigan Dental Association

The ADA Board of Trustees' annual retreat prioritized board development, emphasizing individual strengths and effective communication. Key topics included the Tripartite Membership Model Pilot, a dental school collaboration strategy, and sponsorship for the National Academies of Medicine Oral Health Project. Updates from ADA leaders highlighted initiatives like the Lessons in a Lunchbox program, ADA app improvements, legislative support for young dentists, and workforce solutions. The report concludes with a call to share the ADA story and promote collaboration.

Prevalence And Patterns Of Cardiovascular Risk Factors In Young Hypertensive Patients, *Raghu V S R Tanuku Dr., Major Venkata Shree Krishna Dr., Sreedhar Tanuku Dr

Digital Journal of Clinical Medicine

Hypertension ranks among the top ten causes of mortality, with around 4% attributed to hypertensive complications. High salt intake, Type 2 diabetes, smoking, elevated serum lipids, a sedentary lifestyle, a diet heavy in saturated fat, genetic predisposition, as well as stress are among the factors that contribute to hypertension. Hypertension affects about 1 billion people worldwide, with considerable differences between populations and ethnic groups [2]. The Framingham Heart Study indicates that a person's lifetime risk of developing hypertension is 90% if they are normotensive at age 55. According to the NHANES IV (4th National Health and Nutrition Examination Survey), the …

– Foreign Body Ingestion In Children(<12 Years) At A Tertiary Care Hospital: A Retrospective Cohort Study Studying Role Of Socioeconomic Status And Parental Supervision., Khyati Gupta, Gargi Rekhawar, Anisha Jain, Vishal D. Sawant, Sushma Save

Digital Journal of Clinical Medicine

Background- Foreign body ingestion is a long-standing problem concerning pediatric population. We aim to evaluate the correlation between the median time interval between ingestion of foreign body and arrival to the hospital with socioeconomic factors, effect of parental supervision and number of children in the family. We also aim to find out the deciding factors for proper selection of method of removal of ingested foreign bodies.

Methods- The data was collected from patient’s admission files, medical and endoscopic records. Chi-square test was used to calculate the corelation of time since ingestion with the socioeconomic status of family, method of removal …

“The Study Of Correlation Of Diet Pattern And Anemia In Pregnant Women In A Tertiary Care Hospital In Mysuru-A Prospective Study”, Soniya Pal, Dr Mamatha S Professor And Head Of The Department, Shiva S Dr, Anupama Marnal B A Dr

Digital Journal of Clinical Medicine

No abstract provided.

A Rare Case Of Cold Agglutination Syndrome Secondary To Mycoplasma Pneumoniae, Dr.Disha Shahri, Dr. Srinath K. M, Dr. Basava Chethan, Dr. Savitha Vijayakumar, Dr. Meghna B.S.

Digital Journal of Clinical Medicine

Mycoplasma pneumoniae (M. pneumoniae) is one of the foremost causes of community acquired pneumonia. Most of the cases are, however mild. Although, complications may seldom occur. One such known complication of M. pneumoniae infection is cold agglutinin hemolysis, which is usually benign and transient. This hemolysis is due to formation of cold agglutinins during the course of infection. Cold Agglutination Syndrome (CAS) is a type of acquired Autoimmune Hemolytic Anaemia (AIHA), which exists due to an underlying disorder, like a viral illness or lymohoid malignancy. It is generally self-remitting, in contrast to Cold Agglutination Disease (CAD), which is a chronic …

Assessing Discharge Knowledge For Caregivers Of Newborn (Using Video Discharge Instructions As An Adjunct To Standard Written Instructions) In Covid Period – A Randomized Controlled Trial, Jayesh Yadav, Khyati Gupta, Vishal D. Sawant

Digital Journal of Clinical Medicine

Background: Studies have demonstrated that caregivers of newborn frequently face challenges in comprehending the instructions provided to them upon discharge. Video discharge instructions provide a clear and concise message and can potentially alleviate factors which have an impact on comprehension of caregivers like illiteracy, communication barriers and limited physician time. We aim to assess the impact of incorporating video-based discharge instructions on caregivers' comprehension of newborn care and post-discharge follow-up, specifically in the context of the COVID-19 pandemic.

Methods: Caregivers of newborn in the COVID times were randomized into written only and written with video discharge instruction groups; …

Comparison Of Empathy And Compassion Fatigue Among Mental Health And Non-Mental Health Professionals: A Cross-Sectional Study, Fathima Fiza K T, Anil Kakunje, Ashwini Dinkar

Digital Journal of Clinical Medicine

Background:

Empathy refers to the ability to understand and comprehend others' thoughts and emotions as if it's their own, evoked by witnessing and connecting to the other person’s emotional state. Compassion fatigue, a consequence of an empathetic reaction, is the mental and physical tiredness resulting from being a witness to the suffering of others. It can result in negative consequences ultimately affecting the quality of treatment. The purpose of the study was to compare the level of empathy and compassion fatigue among mental health, and non-mental health professionals.

Methods

A comparative cross-sectional study was conducted over one year using 88 …

A Previous Thyroidectomy- The Culprit Of Laryngospasm Several Years On!, Vyshnavi Sriram, Ashwini N, Chillara Meena

Digital Journal of Clinical Medicine

Laryngospasm is the sustained closure of the vocal cords resulting in partial or complete loss of airway patency. Among the several causes of laryngospasm, history of total thyroidectomy performed several years back, though reported, is a rare occurrence. We present here the case report of a lady with an uneventful intra operative course of a laparoscopic cholecystectomy who developed stridor and laryngospasm in the immediate post operative period. Evaluation revealed unilateral vocal cord palsy and hypocalcemia. Compensated unilateral recurrent laryngeal nerve palsy and asymptomatic hypocalcemia can exist in patients who have undergone total thyroidectomy and can result in stridor several …

Impact Of A Design Thinking Educational Activity On Graduate Students’ Knowledge, Confidence, And Perceived Benefits, Janice Hawkins, John Baaki, Beth Tembley, Robert J. Hawkins

Ellmer School of Nursing Faculty Publications

Background: Design Thinking is gaining recognition as an innovative and creative approach to problem solving. Though nurse leaders need problem solving tools to address health care challenges, Design Thinking concepts are not commonly taught in nursing education. To introduce graduate level nursing students to Design Thinking, we held an educational activity focused on this content as part of required coursework.

Purpose: The purpose was to describe and compare outcomes of a Design Thinking educational activity on students’ perceived knowledge, confidence, and benefits to nursing practice.

Methods: Graduate level nursing students participated in a 3-hour educational activity. After the session, …

A Comparison Of Otolaryngology Residency Applicants Over Time And To Other Surgical Applicants, Matthew E Lin, Khush Kharidia, Deborah Choe, Neelesh Bagrodia, Neil N Luu, Tamara Chambers

Faculty, Staff and Student Publications

OBJECTIVE: Understand how otolaryngology residency applicant characteristics have changed over time and compare them to those of other surgical subspecialties.

STUDY DESIGN: Retrospective analysis of academic, extracurricular, and application data in the Texas Seeking Transparency in Application to Residency databases.

SETTING: Applicants to otolaryngology, neurological surgery, ophthalmology, plastic surgery, urology, and orthopedic surgery applicants from 2019 to 2023.

METHODS: Kruskal-Wallis, Wilcoxon rank sum, Fischer's exact, and Mann-Whitney

RESULTS: Across 4 match cycles and 541 otolaryngology applicants, significant differences were found in the average number of honored clerkships per applicant (

CONCLUSION: Matching into otolaryngology has become increasingly competitive and is …

Assessing Laryngectomy Patient Education On Youtube: Investigating Quality And Reliability, Matthew E Lin, Oluwatobiloba Ayo-Ajibola, Carlos X Castellanos, Jonathan West, Neil Luu, Ian Kim, Niels C Kokot

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to characterize the quality of laryngectomy-related patient education on YouTube and understand factors impacting video content quality.

STUDY DESIGN: Cross-sectional cohort analysis.

SETTING: Laryngectomy-related videos on YouTube.

METHODS: YouTube was anonymously queried for various laryngectomy procedure search terms. Video quality was evaluated using the validated DISCERN instrument which assesses treatment-related information quality. Descriptive statistics were used to characterize our cohort. Univariate and multivariable linear regression were used to assess factors associated with increased DISCERN score. Significance was set at

RESULTS: Our 78-video cohort exhibited moderate levels of engagement, averaging 13,028.40 views (SD = 24,246.93), 69.79 likes …

Management Protocol For Uncomplicated Peritonsillar Abscess: Standardizing Care And Improving Emergency Medicine Resident Confidence., John Casey, Scott Keidel, Marissa Kudo, Miriam Chan

Medical Education Articles

INTRODUCTION: A peritonsillar abscess (PTA) is a frequent reason for a visit to the emergency department. As there are no current published guidelines for medical versus surgical management, attending physicians vary among management tendencies, generating uncertainty among resident physicians. This project established a standard of care for managing patients with PTA and provided clear management guidelines to the emergency department, in collaboration with the otolaryngology department, at a community academic hospital.

METHODS: Pre- and post-interventional, anonymous surveys were given to assess resident physician confidence in the management of PTA. A proposed management protocol was developed based on existing literature and …

Evaluating Native American Serving Nontribal Institutions (Nasnti) Admissions Criteria To Create An Inclusive Nursing Workforce, Tori Stanek

Antioch University Dissertations & Theses

The national nursing shortage is projected to increase as the bulk of the United States population ages out of the workforce and is likely to require more age-related healthcare services. The lack of ethnic, racial, and gender-based diversity in the current workforce exacerbates this shortage, and the need for a diversified workforce acknowledged by governing nursing bodies from as early as 2011 is still largely unmet. This study looks to nursing programs—specifically their application processes—as one factor that contributes to workforce disparities. Guided by several tenets of Tribalcrit Theory (Brayboy, 2005) and the Triarchic Theory of Intelligence (Sternberg, 1985), this …

Family Medicine Resident Scholarly Activity Infrastructure, Output, And Dissemination: A Cera Survey., Bryce A Ringwald, Michelle Taylor, Dean A Seehusen, Jennifer L Middleton

Medical Education Articles

PURPOSE: Meeting scholarly activity requirements continues to be a challenge in many family medicine (FM) residency programs. Studies comprehensively describing FM resident scholarship have been limited. We sought to identify institutional factors associated with increased scholarly output and meeting requirements of the Accreditation Council for Graduate Medical Education (ACGME).

OBJECTIVES: Our goals were to: (1) describe scholarly activity experiences among FM residents compared with ACGME requirements; (2) classify experiences by Boyer's domains of scholarship; and (3) associate experiences with residency program characteristics and scholarly activity infrastructure.

METHODS: This was a cross-sectional survey. The survey questions were part of an omnibus …

Project-Based Learning And Student Outcomes In Health Professions Education: A Literature Review, Melanie Aley, Regina Lee, Jordana Wang, Joy Wang, Sophia Zheng

Health Professions Education

Purpose. Project-based learning (PjBL) is an instructional method designed to help students cultivate skills transferable beyond traditional education systems focused on didactic learning. This literature review aims to critically summarise existing literature on PjBL and its value in tertiary health professions curricula, especially with regards to cognitive, affective and behavioral student outcomes. In doing so, this study seeks to inform teaching and learning approaches that nurture skills desirable in professional settings.

Method. An electronic search for relevant English journal articles was conducted using four databases; EBSCOhost, Medline, Web of Science and Scopus. Studies which pre-date 2012, fail to …

Digital Storytelling As An Innovative Approach To Prehospital Education: The Experiences Of Teaching Academics., Andrew Van Noordenburg, Georgina Seaman

Health Professions Education

Purpose. To explore teaching academics' experiences of utilising digital storytelling as an innovative approach to prehospital education.

Method. This study describes an innovative learning activity, digital storytelling, developed for an undergraduate paramedicine program. The experiences of teaching academics were then explored through semi-structured interviews. Thematic analysis was used to evaluate the data.

Results. Three themes were identified through thematic analysis. The first theme was ‘the impact of friction on learning’ which describes how a learning activity’s design can negatively impact learning. The second theme ‘connecting with the teaching resources’ outlines how having access to sufficient resources is necessary to facilitate …