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2023 | July-December | Volume 7 | Issue 2

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EDITORIAL

Richa G Thaman

Shifting from Competencies to Entrustable Professional Activities (EPAs)

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:2] [Pages No:29 - 30]

   DOI: 10.5005/jp-journals-10055-0172  |  Open Access |  How to cite  | 

105

RESEARCH ARTICLE

Sanjay Kumar, Marlapudi S Kumar, Kashiroygoud Biradar

Comparative Analysis of Ear-packing Materials in Postoperative Recovery: Outcomes and Efficacy

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:5] [Pages No:31 - 35]

Keywords: Complication rates, Cost-effectiveness, Ear-packing materials, Patient satisfaction, Postoperative outcomes, Quality of life

   DOI: 10.5005/jp-journals-10055-0169  |  Open Access |  How to cite  | 

Abstract

Introduction: This study aims to evaluate the optimal type and duration of ear packing for postoperative care in ear surgery, focusing on various outcomes including postoperative complications, pain levels, patient satisfaction, quality of life, and cost-effectiveness. Materials and methods: Conducted as a prospective study in a tertiary care hospital, 100 patients undergoing various ear surgeries were enrolled. Participants were randomly assigned to one of four groups according to the ear-packing material used: absorbable gelatine sponge, silicone-based material, polyvinyl alcohol (PVA) sponge, or chitosan-based material. The duration of ear packing varied among 7, 14, or 21 days. The study focused on evaluating postoperative complications, pain levels, patient satisfaction, quality of life, and cost-effectiveness. Results: The group using the absorbable gelatine sponge reported the lowest rate of postoperative complications (8%) and the highest patient satisfaction (average score: 8.4/10). Pain levels were similar across all groups. Quality of life assessments showed significant improvements in all groups, with the most notable improvement in the absorbable gelatine sponge group. The 14-day packing duration was found to be optimal, showing the lowest complication rates (12%) and highest patient satisfaction scores (average score: 8.1/10). The absorbable gelatine sponge was also found to be the most cost-effective option. Conclusion: The absorbable gelatine sponge emerges as the optimal material for ear packing in postoperative care following ear surgery, particularly with a 14-day duration, balancing complication prevention and patient comfort and satisfaction. Future research should explore the impact of surgeon experience and adjuvant therapies on surgical outcomes.

177

RESEARCH ARTICLE

Rahat Kumar, Jaswinder Singh, Narinder Singh, Vikram Bhandari

The Safety of Covishield (ChAdOx1 nCoV-19) Vaccine after Three Doses Vaccination under Mass Vaccination Program of Government of India

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:7] [Pages No:36 - 42]

Keywords: Coronavirus disease-2019, Covishield, ChAdOx1 nCoV-19, Solicited, Unsolicited

   DOI: 10.5005/jp-journals-10055-0166  |  Open Access |  How to cite  | 

Abstract

Aims and objectives: In coronavirus disease-2019 (COVID-19) disease, there is no antiviral drugs, hence, Covishield vaccination is the best way of prevention. In India, after two doses of vaccination drive, there has been reports of adverse drug events (ADEs) but there has been creation of misinformation about the safety of the vaccine in some reports. Only few studies are available to monitor the ADEs after the third dose of COVID-19 vaccine. Therefore, this study was planned to establish the safety of Covishield vaccine after three doses. Materials and methods: An observational, non-interventional, retrospective study based on surveillance was conducted to assess the safety of Covishield vaccine after three doses. The vaccine was given by Department of Immunization, Preventive and Social Medicine Department, Sri Guru Ram Das Hospital, Amritsar. Subjects were instructed to record solicited/unsolicited adverse reactions in the proforma provided to them in English/Hindi/Punjabi language and were instructed to record ADEs up to 42 days post-vaccination period. Results: A total of 1,364, 1,340, and 1,296 subjects were given the first, second, and third doses of vaccine. The most common solicited ADEs after the third dose with duration was pain at injection site in 48.1% of subjects for 1 day, mild fever temperature ≤100.5°F for 2 days, malaise in 13.1%, injection site swelling in 7%, headache in 5%, myalgia in 4%, chills in 2.5%, rigors in 1.4% of the subjects for 1 day. Adverse drug events seen in subjects with comorbidities were 62.2% after the first dose, 26.2% after the second dose, and 11.4% after the third dose showing a significant reduction in ADEs after each dose. Conclusion: Covishield vaccine is safe and effective after the third dose as compared with the second and first dose.

226

RESEARCH ARTICLE

Sumreen Bhatia, Seep Sonali

A Study of Quality Assessment and Quality Control in an Intensive Care Unit in a Tertiary Care Hospital

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:6] [Pages No:43 - 48]

Keywords: Intensive care unit, Quality assessment, Quality control, Quality indicators, Quality management

   DOI: 10.5005/jp-journals-10055-0170  |  Open Access |  How to cite  | 

Abstract

Introduction: Quality management is the act of supervising all activities and tasks required to maintain a target degree of excellence. The degree of conformance to established standards and criteria is demonstrated by data gathering and analysis. Quality control is a technique designed to ensure that the performance of services conforms to a predefined set of quality criteria in order to meet the patient's requirements. Despite an array of improvement initiatives in hospitals, the quality of care delivered remains open to question. The purpose of this study was to assess the satisfaction level of patients and their attendants, evaluate the quality of care provided in intensive care unit (ICU) and knowledge regarding quality management among ICU staff. Materials and methods: The efficiency of any healthcare unit is judged by its quality indicators. In this study, various quality indicators used in ICU were used. A self-structured questionnaire was filled by the ICU staff members. The Chi-square test was used to determine the association between the score levels and selected demographic variables which showed significance association between the score level and demographic variables such as age, designation, qualification, and experience. Results: Data revealed that 34.3% of patients and their attendants said that the services provided in the ICU were excellent, 42.1% of the patients and their attendants said that they were always satisfied with the services provided in the ICU. The age of the staff, their designation, qualification, and experience were found to be significant, which means that they had effect on the working standards of the ICU staff. Whereas the variables such as gender and marital status had no effect on the working standards of the staff in ICU as they were found to be insignificant. A total of 66.2% of the staff always had the knowledge regarding the working standards in ICU. To sum up it was concluded that that 94.6% practices followed in ICU were good, 5.4% practices followed in ICU were average, and 0% practices followed in ICU were poor. Conclusion: There were various determinants through the result was calculated. The quality of the ICU according to the patients and their attendants was assessed in which 66.7% of the patients and their attendants said the ICU quality was good. The services provided to the patients and their attendants were assessed. The satisfaction level of the patients and their attendants admitted in ICU and assessing the knowledge of the staff working in the ICU was also seen.

167

CASE REPORT

Amandeep Singh, Japsimran Kaur, Guneet

Congenital Diaphragmatic Hernia: Antenatal Sonographic Findings with Review of Literature

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:49 - 52]

Keywords: Bochdalek, Case report, Congenital, Diaphragm, Hernia, Neonate, Pregnancy

   DOI: 10.5005/jp-journals-10055-0164  |  Open Access |  How to cite  | 

Abstract

Background: Congenital diaphragmatic hernia (CDH) is a defect in the diaphragm usually detected on a prenatal scan. The incidence is approximately 1:4,000 live births. The diaphragmatic defect is frequently left and posterolateral (Bochdalek). Surgical repair is possible and easier in neonates; however, the mortality remains high because of pulmonary hypoplasia and pulmonary vascular changes. The likely course of outcome of this condition, largely depends on lung volume on the contralateral side. Purpose: The aim of antenatal imaging is for early detection. This study presents different cases of CDH along with their imaging features on 2D and 3D ultrasonography. Assessment in tertiary care centers would help in identifying the prognostic factors which aid in planning antenatal management. When a defect is identified by ultrasound before 25 weeks of gestation, a careful ultrasound scan may suggest features that have an isolated diaphragmatic abnormality and a great chance of survival. Materials and methods: About 4 cases were evaluated during the second trimester or anomaly scan over a period of 1 year. The scans were conducted between 24 and 30 weeks of gestation and referred to the Department of Radiodiagnosis and Imaging by the consulting obstetrician. On imaging the presence of an abdominal organ, most likely the stomach, within the fetal chest directs the diagnosis toward CDH. On four-chamber view of heart, the stomach is seen just behind the left atrium and ventricle in the lower thorax in a left-sided CDH.

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CASE REPORT

Avi Singh Gandh

Progressive Multifocal Leukoencephalopathy in an HIV-positive Patient: A Case Report

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:2] [Pages No:53 - 54]

Keywords: AIDS-related progressive multifocal leukoencephalopathy, Antiretroviral therapy, Case report, Human immunodeficiency virus, Immunosuppression, John Cunningham virus

   DOI: 10.5005/jp-journals-10055-0168  |  Open Access |  How to cite  | 

Abstract

Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease that occurs as a complication (4–8%) of the John Cunningham (JC) virus in oligodendritic cells. Progressive multifocal leukoencephalopathy is characterized by focal neurological deficits that usually show insidious onset and steady progression. Since the demyelinating lesions can affect various areas of the brain, specific deficits differ from patient to patient. Patients with PML tend to have a prolonged course with multifocal neurological deficits, such as ataxia, hemiparesis, aphasia, and visual field defects that may occur with or without a change in mental status. Here, we present the case of an human immunodeficiency virus (HIV)-positive patient who initially presented with severe headache, vomiting, and generalized weakness, leading to the diagnosis of PML.

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CASE REPORT

Rohit Negi, Sanket Vashist, Karan Inder Singh Mehta, Pushpinder Singh Chauhan, Anuj Sharma, Reena Sharma, Priyanka Thakur, Amisha Kukreja

Digital Gangrene in Early Systemic Lupus Erythematosus: An Uncommon Presentation

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:3] [Pages No:55 - 57]

Keywords: Case report, Digital gangrene, Raynaud's phenomenon, Systemic lupus erythematosus, Vasculitis

   DOI: 10.5005/jp-journals-10055-0165  |  Open Access |  How to cite  | 

Abstract

Systemic lupus erythematosus (SLE) is a multisystem disorder presenting with a myriad of presentations including skin manifestations. However, digital gangrene, despite being sporadically reported in various populations, is a rare presentation, especially in relatively early disease and in absence of antiphospholipid syndrome (APS). A case of digital gangrene in a woman leading up to a diagnosis of SLE with multiorgan involvement in the absence of antiphospholipid syndrome is reported here. She was later diagnosed with SLE, lupus nephritis, skin vasculitis with Libman-Sacks endocarditis, and responded well to conservative therapy.

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CASE REPORT

Manisha Sharma, Jyot Amrita, Mansimran Kaur, Karamjit Singh Gill

Cutaneous Metastatic Deposits of Recto-sigmoid Adenocarcinoma after 7 Years of Surgery and Chemotherapy: A Rarity on Display

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:3] [Pages No:58 - 60]

Keywords: Adenocarcinoma, Biopsy, Cutaneous metastasis, Malignancy

   DOI: 10.5005/jp-journals-10055-0152  |  Open Access |  How to cite  | 

Abstract

Cutaneous metastasis of internal malignant neoplasms is rare and carries a poor prognosis. Colon adenocarcinomas cutaneous metastatic deposits are even rare amounting to approximately 2–4%. A 53-year-old male patient presented with swelling in the lower back region with the clinical diagnosis of an infected sebaceous cyst. The histopathological examination of the excisional biopsy of the lesion revealed adenocarcinoma metastatic deposits in the dermis. The patient was found to be the treated case of recto-sigmoid carcinoma seven years back. Positron emission tomography (PET) scan of the patient suggested colonoscopy correlation to rule out local recurrence at the anastomotic site which was confirmed on the histopathology of the colonoscopy biopsy. So, all the patients diagnosed with any malignancy should be thoroughly examined for any cutaneous metastatic deposits.

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COMMENTARY – MEDICINE AND SOCIETY

Sanjeev Mahajan, Navpreet Kaur

Childhood Trauma

[Year:2023] [Month:July-December] [Volume:7] [Number:2] [Pages:3] [Pages No:61 - 63]

   DOI: 10.5005/jp-journals-10055-0171  |  Open Access |  How to cite  | 

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