Journal of Postgraduate Medicine, Education and Research

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Volume 58, Number 2, April-June 2024
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Vivek Lal

Director's Foreword

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:1] [Pages No:v - v]

   DOI: 10.5005/jp-journals-10028-1668A  |  Open Access | 



Editorial Board Members

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:6] [Pages No:vii - xii]

   DOI: 10.5005/jp-journals-10028-1668B  |  Open Access | 



Surinder Rana

Welcome Message by the New Editor-in-Chief: Striving for Excellence!

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:1] [Pages No:53 - 53]

   DOI: 10.5005/jp-journals-10028-1668  |  Open Access |  How to cite  | 



Jacob Al-Dabbagh

The Impact of the Over a Decade-long War in Syria on Dermatology Residents—A Cross-sectional Study: Part I—The Quality of Education and the Impact of the Deteriorating Economy

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:8] [Pages No:54 - 61]

Keywords: Coronavirus disease 2019, Cross-sectional study, Dermatology, Economy, Medical education, Research, Resident doctors, Syria, Syrian war

   DOI: 10.5005/jp-journals-10028-1664  |  Open Access |  How to cite  | 


Introduction: Starting from 2011, the year that the war in Syria began, the health situation and medical education in Syria have deteriorated, including the training of doctors attending dermatology programs. Moreover, the onset of the coronavirus disease 2019 (COVID-19) pandemic has worsened the health situation and negatively impacted the training of resident doctors in Syria, including dermatology residents (DRs). Aim and objective: This part of the study aims to assess the quality of dermatology training and identify the economic difficulties and challenges that residents faced during their residency period in the absence of necessary tools and expertise. Materials and methods: Similar to the second part of the study, a web-based questionnaire was created in May 2023 and distributed electronically to dermatologists and doctors who joined the residency program (RP) in Syria at any time period from 2011 to 2023. Then, the participants’ data were recorded and analyzed. Results: A total of 192 doctors (female, 167; male, 25), whose average age was 27.63, volunteered to participate in the study from 10 governorates in Syria. This part of the study indicated that there is no standardized dermatology training program for all institutions, which are also not equipped with the necessary tools and teaching methods. In addition, it shows that DRs are negatively affected by the deteriorated economic situation. Conclusion: The dermatological residency programs in Syria must be developed to include all the necessary teaching tools and resources to improve the status of DRs and to familiarize them academically with the means of diagnosing and managing cutaneous disorders. Alternative educational curricula for DRs should also be developed, such as telemedicine, in case of the onset of unforeseen crises or outbreaks in order not to negatively affect their education.



Ramandeep Kaur, Jyoti Kathwal, Anshu Gautam, Ajay Kumar, Akshay Kumar, Avni Saluja, Bharat Sharma, Bhavika Punia

Efficacy of Capacity Building Intervention on Prevention and Identification of Acute Kidney Injury among Nursing Officers of Government Medical College and Hospital Sector-32, Chandigarh

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:7] [Pages No:62 - 68]

Keywords: Acute kidney injury, capacity-building intervention, Efficacy

   DOI: 10.5005/jp-journals-10028-1660  |  Open Access |  How to cite  | 


Aims and background: This study was undertaken to assess the existing level of knowledge related to the prevention and identification of acute kidney injury (AKI) among nursing officers and to assess the efficacy of capacity-building intervention (CBI). An attempt was also made to find the association of participants’ profiles with knowledge scores. Materials and methods: A total of 50 nursing officers were taken from critical care units of Government Medical College and Hospital Sector-32 (GMCH-32), Chandigarh, India. Preexperimental research design was used to assess the knowledge regarding the early identification and prevention of AKI using a self-structured questionnaire. Further, participants were provided with intervention, and after 1 week, a posttest was obtained from them. Results: Statistical data revealed that the majority of the participants acquired average knowledge in their pretest, whereas only a few had good knowledge. It was observed that only 18% had good knowledge regarding the concept of AKI, 12% regarding causes, signs, and symptoms, 6% had related to identification and prevention, and 10% had related to care in their pretest. Whereas in the posttest, 38% had good knowledge related to the concept, 44% (causes, signs, and symptoms), 48% (identification and prevention), and about 28% (care). The association was found between years of experience and that of pretest knowledge. Conclusion: According to the findings of this study, the knowledge of the participants was considerably enhanced after providing CBI in the form of video. Nursing officers had improved their scores in posttest compared to pretest scores. Clinical significance: This study helps the subjects in clinical settings to identify the cases of AKI early, thus reducing the incidence.



Sarita Dhankhar, Rajesh Rohilla, Pankaj K Sharma, Deepshikha Beniwal, Abha Singh

Outcome of Isolated Eccentric Exercise Therapy in Sports Persons with Rotator Cuff Tendinopathy

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:5] [Pages No:69 - 73]

Keywords: Eccentric exercises, Rotator cuff, Tendinopathy, Shoulder, Sports persons

   DOI: 10.5005/jp-journals-10028-1644  |  Open Access |  How to cite  | 


Objective: To evaluate the outcome of an isolated eccentric exercise (EE) program in sports persons with rotator cuff (RC) tendinopathy. Materials and methods: This prospective study enrolled 40 sports persons with a mean age of 26.4 years having shoulder pain with confirmed RC tendinopathy on magnetic resonance imaging (MRI) presenting to the sports injury care center, who were managed with isolated eccentric therapy and stretching exercises. These were managed by routine stretching exercises along with isolated eccentric home-based therapy for 3 months. Functional outcomes were measured as Constant-Murley score (CMS) and disabilities of the arm, shoulder and hand (DASH) score while pain was measured as visual analog scale (VAS) score considered as primary outcomes. Other outcomes were measured as secondary outcomes including a range of movements of the shoulder and isometric abduction strength at 45° in the scapular plane by manual hand dynamometer [handheld dynamometer (HHD)] and shoulder range of motion (ROM) (forward elevation, abduction, and external rotation). All the parameters were evaluated at serial intervals including at presentation and at 3 and 6 months of follow-up visits. Results: With respect to the decline in VAS ratings and DASH score, as well as the large increase in the CMS, there was a considerable improvement in pain and functional results. Mild degression of functional parameters was observed between 3 and 6 months but insignificant biostatistically. Overall muscle strength was improved significantly at the final follow-up than the first presentation. Conclusion: Isolated EE therapy along with stretching is effective in the treatment of sports persons with RC tendinopathy.



Manisha Gulia, Harpreet Singh, Vikas Suri, Ashish Bhalla

Recurrence of Fever after Antitubercular Therapy: Think of Immune Reconstitution Inflammatory Syndrome—A Case Report

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:2] [Pages No:74 - 75]

Keywords: Antitubercular therapy, Case report, GeneXpert Mycobacterium tuberculosis, Nonsteroidal anti-inflammatory drugs, Tuberculosis-associated immune reconstitution inflammatory syndrome

   DOI: 10.5005/jp-journals-10028-1663  |  Open Access |  How to cite  | 


Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is an uncommon phenomenon in an immunocompetent host. It may present in paradoxical and unmasking forms. In any patient with clinical deterioration after an initial response to antitubercular therapy, paradoxical reaction should be kept as an important differential after ruling out resistance to therapy. Here we present a young male with mediastinal and abdominal lymph node tuberculosis having TB-IRIS after 4 weeks of initiation of antitubercular therapy.



Ajeet K Chaurasia, Poonam Gupta, Naincy Purwar

An Unusual Case of Extensive Dry Gangrene with Mummification of Face, Lower Limbs, and Autoamputation of Nose in Sepsis: A Case Report

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:4] [Pages No:76 - 79]

Keywords: Autoamputation, Case report, Dry gangrene, Mummification, Sepsis, Symmetrical peripheral gangrene

   DOI: 10.5005/jp-journals-10028-1666  |  Open Access |  How to cite  | 


Aim and background: The case is exceptional in view of its rarity, lack of medical literature, unfamiliar clinical presentation, and devastating disease course. Case description: An 80-year-old male with extensive dry gangrene resulting from disseminated intravascular coagulation (DIC) in urosepsis due to Escherichia coli. The disease course was devastating, and the patient pleaded for euthanasia due to his debilitating illness, which was denied. Diagnosis: Symmetrical peripheral gangrene (SPG) in sepsis with involvement of face and lower limbs and sparing of upper limbs. Interventions: Strict medical management in the intensive care unit, and thrombolysis was attempted. Outcomes: The patient succumbed to the disease within 2 months of the onset of illness. Clinical significance: Gangrene in sepsis-associated DIC can also involve the face, and the definition of SPG may need an expansion to accommodate that. It is a rapidly progressive condition with a high mortality rate, and a formal consensus needs to be established for appropriate diagnosis and management.



Shreedhara Nagol Shekharappa, Srivatsan Ranga Chari

A Case of Massive Envenomation with Bee Sting: A Case Report

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:3] [Pages No:80 - 82]

Keywords: Anaphylaxis, Bee sting, Case report, Envenomation, Rhabdomyolysis, Urine alkalinization

   DOI: 10.5005/jp-journals-10028-1654  |  Open Access |  How to cite  | 


Envenomation from Hymenoptera stings, including honeybees, wasps, and hornets, usually results in local erythema and edema. Envenomation with bee stings can have varied presentations, from local erythema and systemic reactions (intravascular hemolysis, rhabdomyolysis, acute kidney injury, and liver dysfunction) to anaphylaxis, depending on the number of stings, comorbidities of the patient, and prior sensitization to bee stings. We report a case of massive bee sting envenomation with over 200 bee stings on a patient who presented to our hospital and developed rhabdomyolysis, liver dysfunction, and an elevated troponin I. Early interventions with adequate fluid resuscitation, urine alkalinization, and hepatoprotective measures resulted in a favorable outcome.



Tobias A Brucksch-Domanski, David Humphries

Symptomatic Triradiate Cartilage Injury in a Female Adolescent: A Case Report

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:3] [Pages No:83 - 85]

Keywords: Adolescent, Case report, Magnetic resonance imaging, Overuse injury, Triradiate cartilage

   DOI: 10.5005/jp-journals-10028-1657  |  Open Access |  How to cite  | 


Introduction: The growing adolescent athlete has a significant risk for overuse injury due to multiple intrinsic and extrinsic factors. We present the case of an 11-year-old girl gymnast and multisport athlete with symptomatic stress injury to the right triradiate cartilage. Case description: The injury was recognized on magnetic resonance imaging (MRI) following 6 months of right hip pain with activity. Load reduction strategies did not alter her symptoms, and rest from provocative activity was prescribed. A good outcome was achieved after 6 weeks with resolution of bone marrow edema and pain-free activity progression. Conclusion: We place importance on the recognition of such overuse injuries to avoid long-term sequelae of growth plate injuries.



Brijdeep Singh, Uma Nahar Saikia, Karthi Nallasamy, Anmol Bhatia, Saniya Sharma, Sanjay Jain

Unraveling the Complexity: A Clinicopathological Odyssey of Neonatal Infective Endocarditis and Its Complications

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:10] [Pages No:86 - 95]

   DOI: 10.5005/jp-journals-10028-1667  |  Open Access |  How to cite  | 



Nancy Sahni, Aastha Takkar, Sahil Mehta, Karthik V Mahesh, Ritu Shree, Kamna Bhati, Kamakshi Kalia

Proceedings of the Continuing Nutrition Education Conference 2023: The Impact of Nutrition on Brain Health: From Neurotrophic Factors to Gut–Brain Interactions

[Year:2024] [Month:April-June] [Volume:58] [Number:2] [Pages:8] [Pages No:96 - 103]

Keywords: Deficiency, Degenerative disease, Neurology, Nutrition

   DOI: 10.5005/jp-journals-10028-1661  |  Open Access |  How to cite  | 


The contributions of the present Continuing Nutrition Education (CNE) Conference on “Nutrition and Brain Health” provide a representative overview of gut–brain interactions and their role in acute and chronic brain diseases. Nutrition plays a crucial and lifelong role in brain health. A well-balanced diet can significantly impact cognitive function, mood and overall brain health by influencing brain development and neuroplasticity. Advances in fields like nutrigenomics (the study of how genetics and nutrition interact) and the microbiome are shedding light on the complex relationships between nutrition and brain health. As our understanding deepens, more precise dietary recommendations and personalized approaches to support brain health may emerge. However, there are still some areas where the role of nutrition in brain health remains unclear. These include individual variability, the long-term effects of nutrition, nutrient interactions, the influence of complex dietary patterns, the gut–brain connection and the effects of aging on brain plasticity. The aim of this proceeding is to delve into some of these issues to lay out a comprehensive rundown of the existing knowledge in the field.


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