Journal of Postgraduate Medicine, Education and Research

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2018 | July-September | Volume 52 | Issue 3

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Ajit Avasthi

Stress in Trainee Resident Doctors: What can be Done?

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/jpmer-52-3-iii-vii  |  Open Access |  How to cite  | 


Original Article

Kruthika Nagaraj, Renuka Prithviraj, Rajappa Maheswaran

Retrospective Descriptive Analysis of a University Undergraduate Community Medicine Question Papers, Karnataka

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:5] [Pages No:105 - 109]

Keywords: Blueprint, Community medicine, Evaluation, Undergraduates, Validity

   DOI: 10.5005/jp-journals-10028-1283  |  Open Access |  How to cite  | 


Introduction: Summative assessment of students is done to know whether the student is competent enough for certification. As all assessment methods have some intrinsic flaws, solutions need to be identified to reduce these flaws before implementation. Aim: To evaluate the validity of content in the university undergraduate community medicine question papers and suggest a blueprint format to be used in designing community medicine question paper. Materials and methods: It is a retrospective descriptive analysis. Undergraduate community medicine theory question papers (papers I and II) of the last nine years, from 2008 to 2016, of a selected university in Karnataka were analyzed for content coverage, weightage, etc. Data are expressed as frequency, percentages, median, and interquartile range. Results: Analysis of the question papers revealed that in majority of the papers, there was good coverage of all the chapters. Majority (57.6%) of the questions assessed knowledge followed by comprehension (33.1%), application skills (9%), and only 0.3% questions assessed analysis skills. Majority of the marks were from questions of must-know topics. Conclusion: The present study establishes the scope for improvement while designing question papers in community medicine examinations. Also, blueprint should be an integral part of assessment.



Vinuprasad Venugopalan, Manas Elkal, Rishikesh V Behere, Samir K Praharaj, Haridas Kanaradi

A Study on Alexithymia, Quality of Life, and Facial Emotion Recognition Abilities in Somatoform Disorders

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:7] [Pages No:110 - 116]

Keywords: Alexithymia, Case–control study, Facial emotion recognition, Quality of life, Somatoform disorder

   DOI: 10.5005/jp-journals-10028-1284  |  Open Access |  How to cite  | 


Aim: To assess alexithymia and quality of life among patients of somatoform disorders (SFD) compared with healthy control subjects and to assess the association between alexithymia and facial emotion recognition ability and its influence on quality of life within diagnostic subgroups of SFD. Materials and methods: Forty-three patients diagnosed to have SFD (International Classification of Diseases (ICD)-10) were assessed on the World Health Organization (WHO) SFD symptom checklist, Toronto Alexithymia Scale-26 (TAS-26), Tool for Recognition of Emotions in Neurological Disorders (TRENDS) and WHO Quality of Life (QOL) BREF to measure quality of life. They were compared with a control group of 47 healthy subjects. Results: Patients with SFD had greater alexithymia scores and poorer quality of life compared with controls. A novel observation was the inverse correlation between alexithymia and facial emotion recognition deficit, specifically in the diagnostic subgroup of persistent somatoform pain disorder compared with other diagnostic subtypes. Conclusion: Alexithymia is an important trait influencing quality of life, especially in patients with a diagnosis of persistent somatoform pain disorder and is associated with deficits in facial emotion recognition. Clinical significance: Association between alexithymia and facial emotion recognition is predominant in patients with somatoform pain disorder. Psychological interventions focusing on improving social cognition could potentially play a role in improving the quality of life in patients with persistent somatoform pain disorder.



Farah N Qamar, Khadija N Humayun, Sana Saeed, Arshalooz J Rahman, Hashim Ahmed, Kashif Karim

Effectiveness of a Course on Research Methodology in a Pediatric Residency Program

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:3] [Pages No:117 - 119]

Keywords: Pakistan, Research course, Residency training

   DOI: 10.5005/jp-journals-10028-1285  |  Open Access |  How to cite  | 


Background: The lack of physician's training in research and conducting interdisciplinary/translational or clinical research has been discussed for more than a decade. Little is done to make research methodology as a core curriculum for residency programs, especially in developing countries. The Department of Pediatrics at the Aga Khan University, Pakistan, started a course on child health research methods in 2010 and we report the improvement in knowledge of the residents as a result of introduction of this course. Materials and methods: We conducted a 1-year course with fortnightly sessions to provide an overview of how to plan and conduct a research project. Major topics included identifying research questions, techniques of literature search, basic principles of epidemiology including types of study designs, measures of disease frequency and association, protocol and questionnaire development, basic biostatistics, ethical issues involved in human subject research, and data and bibliography management. For the assessment of impact, the pretest– posttest design was used. Results: Thirty residents filled the pre- and posttest questionnaires. There was significant improvement in the knowledge of basic epidemiology and biostatistics (p = 0.02 and <0.01 respectively). Baseline knowledge of ethics was good and did not improve significantly in the posttest. There was a significant difference in the overall mean pre- and posttest scores [p = 0.014, confidence interval (CI) 1.05–1.7] Conclusion: The research methodology course in the residency curriculum improves awareness and understanding of young postgraduate trainees in basic epidemiology.



Adarsh Kohli, Susanta K Padhy

Profile of Deficits on Assessment Battery in Children with Specific Learning Disorders

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:8] [Pages No:120 - 127]

Keywords: Attention, Disability, Learning, Memory

   DOI: 10.5005/jp-journals-10028-1286  |  Open Access |  How to cite  | 


Learning disabilities affects the acquisition, organization, retention, understanding, or use of verbal or nonverbal information. They usually result from impairments in memory, attention, phonological processing, language processing, visuospatial processing, and so forth leading to inabilities in oral language like speaking and understanding the grammatical constructions, reading like phonetic knowledge and word recognition, written language like spellings and alphabet recognition, and also arithmetic like computation. The aim of the current study is to show the profile in learning disabled children. Brigance Basic Skills List and the National Institute of Mental Health and Neurosciences (NIMHANS) index of specific learning disabilities are used for the purpose. The Brigance Basic Skills List is designed to assess visuomotor skills, visual discrimination, acquisition of gross motor and fine motor skills, and acquisition of alphabets and numbers. The NIMHANS index in addition to the above also assesses the reading, writing, spellings, and arithmetic skills of the subjects and other functions like attention, memory, and perceptual motor functions of the subjects. The sample was drawn from the Child and Adolescent Psychiatric clinic of outpatient of Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. It comprised of 20 subjects within the age range of 10 to 18 years with learning disabilities in one or more areas along with difficulties. They were all belonging to middle- to upper-middle socioeconomic status and were studying in private school setup. The results show the profile of the subjects on attention in terms of distractibility and impulsiveness, the memory profile, perceptual motor functions, basic academic skills in terms of visual and auditory discrimination, concept and sequencing of letters and numbers, and the type of errors in terms of their reading, writing, spellings, and arithmetic skills.



Gabriel Andrade, Saud Qureshi, Saleh Khasawneh, Alladin Kawaiah, Joseph Sarra

Religious Affiliations and Ethical Opinions of Students at Xavier University School of Medicine, Aruba

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:7] [Pages No:128 - 134]

Keywords: Abortion, Euthanasia, Medical ethics, Religion

   DOI: 10.5005/jp-journals-10028-1287  |  Open Access |  How to cite  | 


Xavier University School of Medicine, Aruba, is an offshore medical school located in the Dutch Caribbean. Most of its students come from the United States and Canada. Yet, they are immensely diverse in their religious affiliation. A study was conducted with students, asking them what their religious affiliation is. Then, they were presented with a series of hypothetical cases dealing with abortion, in vitro technology, embryonic stem cells, and euthanasia. They were asked to give their moral evaluation. The results came out showing that, as a general trend, respondents form their ethical opinions in the medical field, independently of the doctrines of their religious affiliations.



Prem L Manhas, Nikita Makkar, Pankaj Malhotra

Advances in Malaria at MICROCON 2016

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:8] [Pages No:135 - 142]

Keywords: Diagnostic methods, Malaria, Markers for drug resistance

   DOI: 10.5005/jp-journals-10028-1288  |  Open Access |  How to cite  | 


Malaria is one of the prevalent vector-borne diseases in India. Though it is a curable disease, failure to recognize it early and increasing resistance to present antimalarial drugs are the major obstacles in its treatment. Thus, irrespective of substantial advancement, there is a demand of supplemental diagnostic methods with high sensitivity and specificity to account for early diagnosis and treatment. Additionally, advanced antimalarial drugs and profound research in pathophysiological mechanism of antimalarial drug resistance is also indispensable. In this review, we have summed up the presentations on malaria that were presented during the 40th Annual Conference of Indian Association of Medical Microbiologists, MICROCON 2016 at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, from November 23 to 27, 2016. Videos of the talks held in the conference are also available on website Major talks were focused on the development of newer diagnostic techniques with high sensitivity and specificity. Further, research on the markers for drug resistance and prevention of spread of drug resistance in malaria was also discussed closely.



Goyal Ashima, Jaiswal Manoj

Multiple Accessory Cusps in Maxillary Primary Second Molars and Permanent First Molars and Its Clinical Implications

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:4] [Pages No:143 - 146]

Keywords: Central cusp, Clinical implications, Dens evaginatus, Multiple accessory cusps

   DOI: 10.5005/jp-journals-10028-1289  |  Open Access |  How to cite  | 


The primary and permanent teeth in humans may show anomalies related to numbers and morphology of crown and roots. There can be a variation in morphology, location, and prevalence of accessory cusps that can often lead to dental problems. The present case report is of a 9-year-old child exhibiting multiple accessory cusps on the occlusal surface of maxillary primary second molars and maxillary permanent first molars. This article highlights the clinical implications of condition and the associated problems.



Goyal Ashima

Oral Self-mutilation: The Rare Neurological Manifestation in a Case of Japanese Encephalitis

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:3] [Pages No:147 - 149]

Keywords: Japanese encephalitis, Japanese encephalitis virus, Self-injurious behavior

   DOI: 10.5005/jp-journals-10028-1290  |  Open Access |  How to cite  | 


Self-mutilation is a behavioral disturbance characterized by the deliberate destruction of or damage to body tissues. This case report describes a 7-year-old child reported with multiple ulcerations in the oral cavity due to self-biting. Intraoral examination showed ulcerations on the left and right buccal mucosa and tongue. Medical history revealed history of fever accompanied by acute onset of flaccid paralysis and encephalopathy. Magnetic resonance imaging brain was suggestive of acute viral meningoencephalitis. Japanese encephalitis (JE) infection was confirmed by immunoglobulin M (IgM) detection. The damage due to self-biting was progressive in nature and the patient's condition did not improve on medication. Extractions of permanent teeth were carried out under local anesthesia to prevent the self-injurious behavior (SIB).



Leszek Sułkowski, Maciej Matyja, Artur Pasternak

Salvage Technique for Complicated Hemodialysis Patients with Central Venous Occlusion

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:3] [Pages No:152 - 154]

Keywords: Central venous catheter, Complications, Hemodialysis, Vascular access, Venography

   DOI: 10.5005/jp-journals-10028-1292  |  Open Access |  How to cite  | 


Background: Although safe, central venous catheters (CVCs) may cause several complications including central venous occlusions. The salvage access techniques are life-saving alternatives required for patients who have exhausted other access options. Technique: We present a technique of placing a permanent catheter in the femoral vein facing the dilated collaterals. This is done in case of iliac vein and vena cava thrombosis following placement of multiple CVCs. Conclusion: This technique might be an effective alternative to the translumbar approach when performed by an experienced operator in a well-equipped access center. It must not be attempted as a blind procedure. Salvaged access can be considered when other access options have been exhausted and only translumbar or transhepatic inferior vena cava accesses are left.


Manoj G Madakshira, Mohd Umair, Phillip Daniel, Kunwer , Ashim Das

Clinicopathological Conference Report

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:9] [Pages No:155 - 163]

   DOI: 10.5005/jp-journals-10028-1293  |  Open Access |  How to cite  | 



Ajit Avasthi, Subho Chakrabarti

Prof. NN Wig... The Living Legend of Indian Psychiatry

[Year:2018] [Month:July-September] [Volume:52] [Number:3] [Pages:2] [Pages No:164 - 165]

   DOI: 10.5005/jp-journals-10028-1294  |  Open Access |  How to cite  | 


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