Addressing Public Health Challenges during Humanitarian Crisis
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:2] [Pages No:1 - 2]
DOI: 10.5005/jp-journals-10082-03155 | Open Access | How to cite |
Qualitative Assessment of Accredited Social Health Activist (ASHA/Mitanin) Regarding their Roles and the Factors Influencing their Performance in Delivering Immunization Services for Children's in Selected Villages of Raipur District, Chhattisgarh
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:5] [Pages No:3 - 7]
Keywords: Epidemiology, Healthcare workers, India, Vaccine
DOI: 10.5005/jp-journals-10082-03130 | Open Access | How to cite |
Background: The Government of India in 2005 started the ASHA program to enhance the health of the rural population. The ASHA (Accredited Social Health Activist) was the important link person between the health system and the community. She supports various national programs along with the childhood immunization service. The study was conducted to know her role and the factors which influence their performance while delivering the immunization services. Methodology: A qualitative study was conducted in Arang block of Raipur. Five villages were selected coming under the sector Mandir Hasaud. Nonprobability purposive sampling was done and in-depth interview was conducted with 18 ASHAs till saturation of the data. Interview findings were analyzed with a thematic frame work. Results: The study shows that the ASHAs have a good knowledge about the routine immunization services. She is clear with her role. Recognition by community and support from family and coworkers were some of the motivating factors. Insufficient and delayed incentives and quality trainings were found to be significant factors in keeping her motivated for providing the immunization services. Conclusion: Regular refresher training, satisfactory monitory incentives, regular disbursal of incentives can be more effective and keep the motivation high for an ASHA for her services delivery in further improving the childhood immunization.
Balanitis Xerotica Obliterans: A Case Report
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:2] [Pages No:8 - 9]
Keywords: Balanitis xerotica obliterans, Circumcision, Lichen sclerosus, Meatal stenosis
DOI: 10.5005/jp-journals-10082-03136 | Open Access | How to cite |
Balanitis xerotica obliterans (BXO) is a variant of Lichen sclerosus (LS) of the glans and foreskin. It is characterized by whitish xerotic patches on the glans. This case report includes two such cases that we encountered in children with complaints of difficulty in micturition and dysuria. They were managed surgically by circumcision and meatoplasty. This article also highlights the importance of screening and awareness of BXO in clinical practice and the need to invest time in evaluating modalities like topical corticosteroids and alternate forms of management in BXO.
Anesthetic Management of Patient with Global Left Ventricular Systolic Dysfunction Posted for Transurethral Resection of Prostrate and Bilateral Hernioplasty
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:3] [Pages No:10 - 12]
Keywords: Epidural anesthesia, Noncardiac surgeries, Subarachnoid block, Systolic dysfunction
DOI: 10.5005/jp-journals-10082-03137 | Open Access | How to cite |
Anesthetic management of cardiac patients for noncardiac surgeries can be challenging and can be associated with both intraoperative and postoperative complications. Care of these patients requires identification of risk factors, preoperative evaluation and optimization, medical therapy, monitoring, and the choice of appropriate anesthetic techniques and drugs. A 70-year-old male, with past history of cardiovascular accident (CVA) and no other known comorbidities, had complaints of lower urinary tract symptoms, gradually worsening over the past 20 days and developed urinary retention 4 days back, diagnosed with benign prostatic hypertrophy (BPH), after obtaining a 2D echo [showing global hypokinesia with severe left ventricular (LV) systolic dysfunction, ejection fraction (EF)-30%] with cardiologist opinion posted for transurethral resection of prostrate (TURP) and bilateral hernioplasty under regional anesthesia (lumbar epidural anesthesia with subarachnoid block—1.2 mL of 0.5% bupivacaine with 25 µg fentanyl), under moderate cardiac risk. The patient was hemodynamically stable intraoperatively and perioperatively. The patient was continuously monitored perioperatively and cardiac drugs like diuretics, beta-blockers, statins, and angiotensin receptor neprilysin inhibitor (ARNI) were continued after obtaining a cardiologist review. Thus in patients with moderate risk cardiac illness, who are posted for noncardiac surgeries, the more preferable and safer alternative is regional anesthesia as it reduces the sympathetic stress response which is present while performing general anesthesia (during intubation and extubation).
Why Not Thoracic Epidural Anesthesia in Modified Radical Mastectomy?! A Case Report
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:2] [Pages No:13 - 14]
Keywords: Epidural analgesia, Modified radical mastectomy, Ropivacaine, Thoracic epidural anesthesia
DOI: 10.5005/jp-journals-10082-03138 | Open Access | How to cite |
Thoracic epidural anesthesia (TEA) is a forthcoming alternative to general anesthesia for modified radical mastectomy. A 49-year-old female who is a known case of chronic obstructive pulmonary disease/diabetes mellitus/hypertension and body mass index of 35.8—OBESE II (which makes regional anesthesia challenging) with a diagnosis of right CA breast posted for modified radical mastectomy (MRM). The case was planned only under TEA. The patient was induced with a loading dose of 15 mL of 0.5% ropivacaine at the T4–T5 level. The patient was comfortable throughout the procedure and uneventful. The patient was discharged on the 5th postoperative day. TEA provides advantages of superior postoperative analgesia without adverse effects of general anesthesia (GA) like nausea and vomiting. TEA enhanced patients’ compliance with chest physiotherapy.
Type-II Neurofibromatosis with Cervical Schwannoma Posted for Emergency Lower Segment Cesarean Section under Sole Epidural Technique
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:2] [Pages No:15 - 16]
Keywords: Autonomic hyperreflexia, Cervical schwannoma, Epidural anesthesia, Type-II neurofibromatosis
DOI: 10.5005/JP-JOURNALS-10082-03139 | Open Access | How to cite |
The prevalence of neurofibromatosis type-II is rare (1 in 33,000 people) worldwide with uniform gender distribution. Patients commonly present with vestibular schwannomas or any of the two among meningiomas, schwannomas, gliomas, cutaneous neurofibromas, posterior subcapsular lenticular cataracts, or cortical wedge cataracts. Pregnancy tends to promote the growth of such preexisting tumors and may reveal an untrodden tumor. This report describes a parturient who had neurofibromatosis type-II presented with cervical schwannoma posted for an emergency lower segment cesarean section (LSCS). General anesthesia is the preferred choice but owing to the restricted neck movements and high risk of autonomic dysreflexia in presence of cervical schwannoma, sole epidural anesthesia was performed successfully.
Occam's Razor? Not Always..! A Case Report of Acute Myocardial Infarction in a Patient with Fungal Pneumonia
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:2] [Pages No:17 - 18]
Keywords: Acute myocardial infarction, Community acquired pneumonia, Fungal pneumonia
DOI: 10.5005/jp-journals-10082-03141 | Open Access | How to cite |
Pneumonia is a leading cause of mortality worldwide. Cardiovascular problems affect up to 30% of patients admitted to hospitals for community acquired pneumonia (CAP), both immediately and up to 10 years afterward. Here we present a case of elderly patient with fungal pneumonia who developed acute myocardial infarction (AMI) on day 2 of admission. Pre-existing diseases, relative ischemia, sympathetic system activation, systemic inflammation, and direct pathogen-mediated injury to the cardiovascular system all play a role in cardiac problems. The actual processes governing direct host–pathogen interactions are of tremendous interest in the search for prospective CAP therapeutic and preventive strategies.
Role of Technology in Medical Education: SWOC Analysis
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:3] [Pages No:19 - 21]
Keywords: COVID-19, Medical education, Technology
DOI: 10.5005/jp-journals-10082-03131 | Open Access | How to cite |
The traditional methods of medical education were dependent and restricted on the mainstays of printed textbooks, chalkboards, photographic projection-based classroom lectures, and cadaver dissection laboratories. Due to revolutionary changes in the medical curriculum of undergraduate and postgraduate training, there is a rapid transformation from knowledge-based to competency-based education patterns. In a very precise way, utilization of the modern teaching aids has led to optimization of medical students’ engagement by acclimatization to the dynamic and exhaustive medical curriculum in the best way possible even in the unprecedented times of coronavirus disease-2019 (COVID-19). In conclusion, gradual and systematic digitalization of learning of medical students should be synchronized with the traditional didactic lectures to have maximum compliance with the current model of medical education. However, this could be only possible when both the learner and the faculty are competent enough to utilize modern teaching and learning aids of technology to get the best outcomes from the process of teaching, learning, and assessment.
COVID-19 Pandemic and Contact Tracing
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:3] [Pages No:22 - 24]
Keywords: Contact tracing, COVID-19 pandemic, World Health Organization
DOI: 10.5005/JP-JOURNALS-10082-03140 | Open Access | How to cite |
The coronavirus disease-2019 (COVID-19), which caused loss of massive lives and is still continuing to do so, was initially observed to cause severe illness and deaths in Wuhan (China) around December of 2019. The virus spread at a very fast pace all around the world extensively which made the World Health Organization (WHO) to declare a pandemic on March 11, 2020. Contract tracing is an effective method for containment of infectious like coronavirus disease. It is a method in which a lead case with confirmed COVID infection is enquired about the people he contacted during the period when he was possibly infective as the contacts were at a very high risk of obtaining infection from the lead case. The contacts are then traced and counseled about the risk of infection, quarantined, and tested if necessary as per the countries testing guidelines. Contact tracing is an efficacious method which can prevent the transmission of infection by identification of infected individuals, their isolation and care depending upon the severity of the disease (home isolation/hospitalization), and also investigation of the individuals which were exposed to them and isolating them for the required period if necessary so that virus transmission can be stopped. To conclude, contact tracing is definitely an important measure to control, prevention as well as the spread of coronavirus disease as respiratory droplets are the main form of spread of the virus. It is equally effective against all the strains of the virus irrespective of its virulence.
[Year:2022] [Month:January-March] [Volume:5] [Number:1] [Pages:2] [Pages No:25 - 26]
Keywords: COVID-19, Doctors, Violence
DOI: 10.5005/jp-journals-10082-03132 | Open Access | How to cite |
On April 5, 2020, on request from the Honorable Prime Minister, the nation lit candles at 9 pm for 9 minutes. The goal behind this act was to show unity of the nation in its fight against the coronavirus disease-2019 (COVID-19) pandemic and also as a gesture of respect toward the healthcare workers helping fight it. So, while to an outsider it may seem like the doctors in India are put on a pedestal, the ground reality tells a whole other story. A recent study has found that 75% of doctors are likely to face some form of abuse in their workplace. There is an immense need to bring about a change and that has to come fast. The new generation of doctors need to be trained for better communication. However, there also needs to be better infrastructure in place to facilitate doctors to work to their utmost capacity. Today, more than ever, there is a dire need to bridge the gap between civilians and doctors. Doctors and their knowledge and skills, which they spent years learning, need to be appreciated and trusted more. Measures have to be taken by the government and other agency to ensure that the white coat of a doctor gets painted no more in red.