Medical Education: Past, Present and Future |
Author : Satish Tiwari |
Abstract | Full Text |
Abstract :The concept of healthcare is ancient irrespective of color, caste, creed, race, religion or
geographical distribution of human beings. The present era has witnessed many
cultural and traditional gyrations and upheavals. Most of the ancient values have been
declared as outdated or backward and newer and newer values are accepted as
modern or advanced. Many feel that health is one of the basic and fundamental human
rights. The Constitution of India recognizes the health of an individual as a fundamental
right. India is a signatory to the Alma-Ata declaration of 1978, which indicates India’s
commitment to the goal of “Health for All by the 2000 AD.”
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This has prompted the
government to start many health-related services or schemes to fill up the “Health
gaps.” The concept of “an acceptable level of health that will enable every individual to
lead a socially and economically productive life” came in existence. The healthcare or
medical education was practiced as an art in the past. Presently,the medical education
is practiced as a science but many of us are now practicing it as a commercial venture.
Medicine will continue to evolve so long as man’s quest for better health continues.
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Identifying Competencies in Community Medicine: An Explorative Study in a Medical College in Delhi |
Author : Jugal Kishore1 , Charu Kohli2 , Tanu Anand3 , Urvi Sharma4 , Drishti Sharma |
Abstract | Full Text |
Abstract :Background: Role of medical education at the undergraduate level hasbeenconsidered
of utmost importance as it sows the seeds on which the foundations of a budding
doctor are built. Need of the public health competencies among medical graduates is
important because these will enable them to provide primary healthcare to the
community.
Aims and Objectives: To identify various competenciesthat are needed in community
medicine and to assess the competencies developed among undergraduate medical
students after field posting in community medicine.
Methodology: 30 faculty members across the country were sent an open-ended
questionnaire to list out core competencies needed for undergraduate medical
studentsin communitymedicine. On the basis of competencieslistsuggestedby faculty
members, a self-appraisal questionnaire was designed and distributed to students
studying in 4/5 semester and 6/7 semester and also to one batch of students after
completion of field posting in community medicine in a medical college in New Delhi.
During the study period, a total of three batches were covered where 118 students
from 4/5 semesters and 109 students from 6/7 semesters completed their
questionnaires. Allstudents who had completed their questionnaires were included in
the study and for analysis. Fromone batch consisting of 38 students of 7 semester,preand
post-field posting competencies were assessed. |
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Assessment of Violent Recidivism and Psychopathy in the Mentally Ill Prison Inmates using VRAG (Violent Risk Assessment Guide) - A Pilot Study in Mysore |
Author : Mudassir Azeez Khan1 , Shreyas Gomedic Ramachandra2 , Julian Gojer3 , Anand Reddy4 , Prashantha Bettappa |
Abstract | Full Text |
Abstract :Introduction: Psychopathy is associated with criminal behaviors and is linked to violent
recidivism. Birth order, family size, educational attainment and substance abuse
influence psychopathic traits and it remains to be examined if these factors also have
an effect on violent recidivism. VRAG (Violent Risk Appraisal Guide) is an actuarial risk
assessment instrument that is intended to estimate violent recidivism in the forensic
psychiatric subjects.
Aim: To predict violent recidivism and examine its association with psychopathy and
factors such as birth order, educational attainment, sib-size, age of the prison inmate
and age at offence in the mentally ill prisoners in an Indian sample in Mysore Central
Prison.
Method: The VRAG test was administered on a sample of 15 prisoners who were
diagnosed mentally ill. All data were entered into SPSSw18 and analyzed using Pearson
correlation test for correlation between variables.
Results: PCL-R (Hare’s Psychopathy Checklist-Revised) score did not show any
association with violent recidivism predicted by VRAG instrument. Birth order did have
an association with predicted score of violent recidivism (r=-0.608, p=0.036). There was
also a correlation between the commissions of non-violent offenses with predicted
VRAG scores of violent recidivism (r=0.61, p=0.046). Size of female siblings had a
moderating effect on re-offense (r=-0.694, p=0.012). Both educational attainment and
sib-size are associated with early criminal violence(r=-0.59, p=0.04 for both). Sib-size is
negatively correlated with educational attainment (-0.715, p=0.09) |
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Peer-Assisted Learning and Lecture Method: Comparison in a Medical College in Delhi |
Author : Jugal Kishore1 , Charu Kohli |
Abstract | Full Text |
Abstract :Introduction: Teaching and learning in medical education has always been challenging
for medical educators. There are various teaching and learning methods used in
medical education with inherent strengths and limitations of each method. This study
was aimed to assess the effectiveness of peer-assisted learning (PAL) and lecture
method in medical students in a teaching hospital in Delhi.
Materials and Methods: An intervention comparative study was conducted to assess
the effect of PAL as compared to conventional lecture method among undergraduate
medical students. Out of 250 students, only one batch of 50 was selected for the
intervention. The students of the same batch were taught two different topics in
community medicine - occupational health and malaria.Occupationalhealthwastaught
using lecture as a teachingmethod. Malaria wastaught using assisted-learningmethod
where groups of students were told to prepare and discuss among themselves. Ten
multiple-choice questions were prepared on each topic for evaluation of theirlearning
in cognitive domain. Scores were calculated before and after the interventions and
compared. Paired t-test was used in pre-and post-interventionscoreswhereas between
the two methods scores, Mann Whitney U test was used. |
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Visual Field Mapping by Tangent Screen and Humphrey Perimetry: A Comparative Study |
Author : Jaideep Singh Bhalla1 , Madhavrao Satyanarayanan2 , Ajay Kumar Jain3 , Ruchi Goel4 |
Abstract | Full Text |
Abstract :Background and Objectives: (a) To compare manual tangent screen perimetry and
automated Humphrey perimetry for visual field testing, and (b) to analyze whether
manual tangent screen perimetry still has a role or it should be replaced by
computerized automatedHumphrey perimetry in physiology labsandclinicaldiagnostic
settings.
Methods: Study was done on 45 patients between 18 and 65 years of age that included
30 eyes of patients suffering from glaucoma/ other eye diseases giving rise to visual
field defects, 5 eyes of patients suffering from neurological diseases and 10 eyes of
normal subjects.
All patients underwent perimetry examination by tangent screen at 1 meter distance
(and 2 meter distance, if required) and automated Humphrey perimetry by Humphrey
visual field analyzer (HFA) using 30-2 ‘white on white’ full threshold strategy. Tangent
screen consists of black screen 2 metersquare or 1 metersquare. Accordingly, patient
is seated at a distance of 2 meter or 1 meter respectively. A patient with organically
constricted visual fields willshow an increase in the size of the visual field whenmoved
to a farther distance while a patient with functional visual field loss will oftenreportthe
same absolute size of the field (tubular or gun-barrel field) to be consistent with their
first field. This is clear evidence of functional visual field impairment. |
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Prevalence of Halitosis and Validation of an Instrument to Compare Self-Perceived Halitosis and Measured Halitosis in Senior Secondary School Children of North India |
Author : Nikita Mehta1 , Manoj Kumar2 , Amarjeet Singh |
Abstract | Full Text |
Abstract :Introduction: Halitosis is a very common problem and is experienced by majority of
the population, but few persons perceive this problem whereas they actually do not
suffer from it. Halitosis not only becomes a disease but also poses a social and
psychological problem.
Objective: To ascertain the prevalence of halitosis, document various measures to
control halitosis and to validate an instrument used to measure the levels of
halitosis against self-perceived levels of halitosis among school children.
Materials and Methods: A descriptive cross-sectional study was conducted in a
senior secondary school of Panchkula (Haryana). Data was collected using selfstructured
questionnaires that consisted of items on knowledge and perceptions on
halitosis. An instrument was used to measure and compare levels of halitosis.
Results: Majority of the subjects experienced self-perceived halitosis, among which
61% rated their problem of halitosis as weak, and 9% as intense. 34.3% associated
their problem of halitosis with dental caries. 38.7% thought that halitosis was due to
their problem of bleeding gums, whereas 18.9% associated their problem with food
lodgment. Majority of subjects, i.e., 33% practiced flossing to eliminate bad breath,
followed by 24% subjects who went in for scaling and curettage, followed by 20%
who used tongue scrapers, followed by 15% who went in for restorative treatment
for dental caries, followed by 8% who used interdental brushes. |
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Unconsciousness with Stable Cardiovascular System Following Interscalene Block |
Author : Gaurav Acharya1 , Brijesh Kumar Gupta2 , KK Arora3 , Dewesh Kumar |
Abstract | Full Text |
Abstract :The interscalene block (ISB) is a regularly used anaesthesia technique for most of
surgeries done on the upper limbs and shoulder. Overall, it is considered safe but it may
be associated with common complications like Horner’s syndrome, phrenic nerve block,
hoarseness, etc., and rare but serious complications like extensive neuroaxial blocks,
intravascular injection and systemic toxicity. These are associated with respiratory
arrest and loss of consciousness.
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If ISB is given after general anaesthesia, loss of spinal
cord function can occur if local anesthetic is injected in the spinal cord.
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In this article,
we will be presenting a probable sudden subdural block, which is different from the
slow subdural block, which has been reported before3
as a possible complication of ISB.
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Problem with the UG Curriculum and Solutions: Group Discussion |
Author : Shamrendra Narayan1 , Dipti Agarwal |
Abstract | Full Text |
Abstract :Health for all shall remain a mirage till the gap of health professional and population
remains high. To meet this goal, not only the number but also the quality of Indian
medical graduates needs to be re-looked. There are many problems associated with
undergraduate curriculum. In a MCI revised basic course workshop in medical
education technologies for MEU coordinators/ MEU co-cordinators and MEU
resource faculty, a group discussion was organized at Maulana Azad Medical College,
New Delhi. In the discussion, following hindrances were identified with possible
suggestions to improve the standard of medical education in India:
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