Current Medicine Research and Practice

Lymphangitic carcinomatosis Publication date: Available online 21 May 2019 Source: Current Medicine Research and Practice Author(s): Dr Shelly Sharma, Dr KK. Saxena, Dr Amena Nayyer

Effectiveness of Self-Instructional Module on Knowledge, Attitude and Practice regarding Pharmacovigilance among Staff Nurses. Publication date: Available online 20 May 2019 Source: Current Medicine Research and Practice Author(s): Sudeshna Banerjee, Sumity Arora, Gigi John, Siddhartha Dutta, Raminder Kalra, Rita Sapra Abstract Introduction Drugs with beneficial effects do come with adverse effects called adverse drug reactions (ADRs) which may even lead to fatal reactions. Hence, awareness about ADRs among health care professionals is an essential component for a healthy healthcare system. Objective This study was carried out to assess the effectiveness of self-instructional module on existing knowledge, attitude and practices (KAP) regarding pharmacovigilance. Materials and Methods A quasi-experimental approach with a repeated measure design was used to compare the pre and posttest assessment. Based on the reviews of previous research articles and literature on pharmacovigilance the KAP questionnaire and self-instructional module was developed. A total of 60 nurses were included in the study. Assessment was done on a validated and modified structured KAP questionnaire which included 35 items 20 items related to test knowledge, eight to test attitude and seven to test practice. Thirty minutes were allotted to fill up the questionnaire. Filled up questionnaires were collected after the pre-test and the self-instructional module was given to them after the test and were instructed to study the module properly during the next seven days.. After the completion of seven days, KAP questionnaire was readministered to them for the evaluation of post-test. Results Post-test performance significantly improved over the pre-test indicating the effectiveness of the educational self-instructional module on pharmacovigilance. Conclusion Self-instructional module on pharmacovigilance should be given priority and become a regular mandatory learning component of the nursing staffs.

Bioterrorism: Clinical and Public Health Aspects of Anthrax Publication date: Available online 16 May 2019 Source: Current Medicine Research and Practice Author(s): Tulsi Chugh Abstract Bioterrorism is intentional use of bioweapons (bacteria, viruses, fungi or their toxins) to harm persons, animals, agriculture or environment of a country. Its impact can cause high mortality and morbidity and serious disruption of economy and social and political life. Countries must be fully equipped to respond through adequate surveillance systems and management, containment and preventive policies.

Duty-Hour Flexibility in Surgical Training- Is it necessary or possible to implement in Indian hospitals? Publication date: Available online 13 May 2019 Source: Current Medicine Research and Practice Author(s): Shailendra Lalwani, Samiran Nundy

Adrenal and skeletal Lesions - A Diagnostic dilemma Publication date: Available online 13 May 2019 Source: Current Medicine Research and Practice Author(s): Manuj Sondhi, Nakul Gupta, Atul Kakar, Atul Gogia Abstract Extensive skeletal involvement in any elderly is highly suspicious of malignancy. A simultaneous occurrence of lesions elsewhere strengthens the case for a detailed search of the primary. Despite the numerous advanced modalities at our disposal, differentiating between malignant, infectious and inflammatory lesions often presents a diagnostic dilemma. Here, we report a case of an elderly gentleman who presented to us with multiple bony lesions. A further evaluation revealed a concomitant adrenal and liver involvement mimicking metastasis which later was found to be disseminated tuberculosis.

Industry 4.0 applications in medical field: A brief review Publication date: Available online 19 April 2019 Source: Current Medicine Research and Practice Author(s): Mohd Javaid, Abid Haleem Abstract Background Industry 4.0 is an established reality that seems to fulfil various requirements of the medical field, with extensive research going on in this area. Thus, there is a need to understand how Industry 4.0 can be a useful paradigm to fulfil various requirements of medical field using different technologies. Aim of this work The purpose of this study is to understand the role of Industry 4.0 in the medical field and identify research status along with future applications. Materials and methods Research articles on Industry 4.0 in medical and related fields were studied to identify applications and research direction. Result Through this study, we identified different technologies, capabilities and research status of Industry 4.0 in the medical field. Furthermore, we have also identified 19 important applications of Industry 4.0 in the medical field to provide a significant contribution to the research and development of new medical models and devices. Industry 4.0 seems to be an essential part of tomorrow's medical field and smart factories, where software, technologies and processes provide efficient and world-class results with lesser time and cost. Conclusion Industry 4.0 shows the extensive capability of manufacturing of newly customised implants and innovative tools and instruments for the medical field. It provides a type of digital hospital and a complete monitoring system that fulfils the individual requirements of the patient/medical industry with optimised time and cost. Industry 4.0 is an innovative approach to generate new concept and undertake development in the medical field through the integration of technologies, smart machines and different software. Industry 4.0 manufactures high-quality, regulated medical devices which are highly customised as per patient requirements. This revolution embraces automation and creates new manufacturing opportunities in the medical world. With the help of the Internet of things (IoT) and the Internet of services (IoS), it creates a new virtual world. It creates connectivity and data exchange with the help of new manufacturing technologies, software, sensors, robots and other advanced information technologies. In future, Industry 4.0 can create new opportunities and innovative routes for patient care.

Is the comparison of Indian research output to well-known centers a global ranking? Publication date: Available online 16 April 2019 Source: Current Medicine Research and Practice Author(s): Abhishek R. Payal, Ritam Chowdhury

Study of relationship between glycosylated hemoglobin and platelet activity measured by mean platelet volume in patients with diabetes mellitus Publication date: Available online 4 March 2019 Source: Current Medicine Research and Practice Author(s): Manoj Saluja, Yogesh Kumar Swami, Saurabh Chittora, Hemant Vimlani Abstract Background The increased platelet activity may play a role in the development of vascular complications in diabetics. The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Larger platelets are younger and exhibit more activity. Objectives The objective of this study was to determine the MPV in diabetics with different glycemic control; to see if there is a difference in MPV between diabetics with and without vascular complications; and to determine the correlation of MPV with fasting blood glucose, glycosylated hemoglobin (HbA1c), body mass index, and duration of diabetes. Methods Platelet counts and MPV were measured in 160 patients with type 2 diabetes using an automated blood cell counter. The blood glucose levels and HbA1c levels were also measured. All patients were divided in 2 groups: group A, which includes patients with HbA1c ≤ 8%, and group B, which includes patients with HbA1c > 8%. Results The mean platelet counts and MPV were higher in group B than in group A (P = 0.16 and 0.0001, respectively). MPV showed a positive correlation with fasting blood glucose [regression (r) = 0.18] and HbA1c levels (P = 0.0001). HbA1C and MPV increase with increase in duration of diabetes mellitus (p = 0.49 and 0.50, respectively) in both groups with duration >5 years and ≤5 years. Conclusion Elevated MPV could be either the cause for or due to the effect of the vascular complications. Hence, MPV can be used as a simple parameter to assess the vascular events in diabetes.

Clinical spectrum of acute abdomen in children admitted to pediatric emergency department: A prospective study Publication date: March–April 2019 Source: Current Medicine Research and Practice, Volume 9, Issue 2 Author(s): Rupa Banerjee, Alpana Prasad, Suresh Gupta Abstract Introduction Acute abdominal pain accounts for about 8% of all children attending the emergency department (ED) (Balachandran et al., 2013). In spite of being a common symptom seen in children, it is not uncommon for it to be a manifestation of a serious surgical emergency. There are inadequate published data from India regarding the spectrum of acute abdominal pain in children. Objective The objective of this study was to assess the clinical profile of children with nontraumatic acute abdominal pain admitted in the pediatric ED. Methodology This prospective observational study was conducted between June 2016 and July 2017. All the records of children aged between 2 and 18 years presenting with complaints of abdominal pain were collected in a predesigned proforma at the time of admission in the pediatric ED. Children who had undergone previous abdominal surgery and those with a history of trauma were excluded. Results A total of 720 children attending ED with complaints of abdominal pain were seen by the surgical team. According to their final diagnosis, they were divided into two groups: group I, 58 (8%; surgical); group II, 662 (92%; nonsurgical). Mean age of presentation was 7.5 ± 5.7 years; male-to-female ratio was 1.6:1. Detailed history and pain characteristics help in establishing the cause of pain. Conclusion The cause of pain in more than 90% of children presenting in the pediatric ED with complaints of abdominal pain is nonsurgical. Constipation was the most common diagnosis in these children, followed by acute gastroenteritis. Only in 8% children, the cause of pain is surgical, and acute appendicitis is the most common surgical cause.

Central nervous system involvement in dengue: A tertiary care centre study Publication date: March–April 2019 Source: Current Medicine Research and Practice, Volume 9, Issue 2 Author(s): Manoj Saluja, Yogesh Kumar Swami, Saurabh Chittora, Hemant Vimlani Abstract Background Recent studies have shown dengue viral infection causing encephalopathy, with high morbidity and mortality. Patients with dengue encephalopathy usually present with altered sensorium, elevated lab parameters, and high antibody titers at the time of admission. Objectives The objective of this study was to study the clinical presentation, lab parameters and diagnostic features, and management and outcome of patients with dengue encephalopathy in Hadoti region in the period of August to November, 2017. Methodology The study was conducted in the Government Medical College Hospital, Kota and in other multispecialty hospitals in Kota. Study population comprised 60 patients presenting with febrile illness and thrombocytopenia, serologically proved to be having dengue fever. Among these 60 patients, 30 patients had encephalopathy and the remaining 30 had no signs and symptoms of encephalopathy. Results Among 30 patients with encephalopathy and positive serology, fever and altered sensorium were the most common symptoms. Out of 30 patients with encephalopathy, 16 patients had convulsions, 14 had respiratory distress, 17 had shock, and 3 had hemiplegia. Two patients also had visual blurring and dysarthria. Mean duration between appearance of fever and altered sensorium was 4.6 (±2.1) days. Most of the patients with encephalopathy had deranged hepatic, renal, and coagulation parameters. Nine patients with encephalopathy died. Conclusions Increased incidence of dengue encephalopathy in the recent years, in the absence of single sensitive test and with variable cerebrospinal fluid and magnetic resonance imaging brain features and associated high morbidity and mortality, poses a huge problem for clinicians. This study may be helpful in focusing on early diagnosis and aggressive initial management that can influence the final outcome.

Alexandros Sfakianakis
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