Journal of Postgraduate Medicine, Education and Research

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2023 | April-June | Volume 57 | Issue 2

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EDITORIAL

Samir Malhotra

An Unknown "Q" Variable in Pharmacotherapy

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:3] [Pages No:53 - 55]

   DOI: 10.5005/jp-journals-10028-1624  |  Open Access |  How to cite  | 

191

RESEARCH ARTICLE

Puneet Nagpal, Milan Bagla, Rohit Mahajan, Manpreet Singh, Akshay Sharma, Sushmita Ghoshal, Niranjan Khandelwal

Awareness of Oral Cancer among Residents of Chandigarh

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:4] [Pages No:56 - 59]

Keywords: Early detection, Oral cancer awareness, Survey questionnaire

   DOI: 10.5005/jp-journals-10028-1602  |  Open Access |  How to cite  | 

Abstract

Background: According to Hospital Based Cancer Registry (HBCR) data from Chandigarh, oral cancers account for 30% of all head and neck cancers, and most of these present with advanced diseases. Awareness programs were conducted to encourage oral self-examination for the detection of cancer. Materials and methods: The services of the existing mobile van for cancer detection were utilized to display posters and educate people about oral self-examination. Initially, a form with five direct questions was filled out by all the participants. These answers were analyzed in order to assess the awareness of the participants. Results: A total of 281 adults (168 males and 113 females) participated. Among them, 221 denied the use of tobacco in any form. More than 90% of them were aware that the use of tobacco could cause cancer, and about 78% were aware of the harmful effect of passive smoking. Only 72% were familiar with the early signs of oral cancer. Among tobacco users, 91.7% were aware of its carcinogenic effect. Conclusion: Most of the participants seemed to be aware of tobacco-causing cancer and the early signs of oral cancer. However, they are part of a highly motivated group who were primed with several exposures to cancer awareness exhibitions. Cancer awareness programs need to be widely conducted in the community to increase awareness and aid cancer control.

303

RESEARCH ARTICLE

Diksha Gandhi, Karthick Rangasamy, Nirmal Raj Gopinathan

Baseline Hamstring Excursion in Indian Pediatric Population: A Pilot Study

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:5] [Pages No:60 - 64]

Keywords: Cerebral palsy, Children, Excursion, Hamstring, Hamstring shift test, Popliteal angle

   DOI: 10.5005/jp-journals-10028-1604  |  Open Access |  How to cite  | 

Abstract

Background: Hamstring muscles are primarily affected by many neuromuscular or musculoskeletal conditions, due to which the patient has to suffer various limitations. One must be aware of the hamstring excursion in normal healthy children to recognize the pathological conditions. To the best of our knowledge, no such data is available from the Indian pediatric population to date, so it was considered worthwhile to conduct this study. Materials and methods: This study was conducted to analyze the limits of hamstring excursion in 50 normal Indian children (aged between 6 and 18 years) using three routinely used tests in the orthopedic outpatient clinic. The tests included are the straight leg raising test (SLRT), popliteal angle unilateral (PAU) and popliteal angle bilateral (PAB), and toe touch test (TTT). The results were based on differences in gender, age-group, and sides (left and right). Results: The mean value of the SLRT was 60.16° and 57.02° in children <12 years (group I) and ≥12 years (group II), respectively. The PAU values were 42.66° for group I and 46.44° for group II, while the TTT results were −0.69 and −5 cm, respectively. Minimal variation was seen between both sides in all three tests. When comparing the data based on gender, the mean value of SLRT was 62.64° and 56.21° for girls and boys, respectively. The PAU values are 43.26° and 45.39°, while the TTT had a mean of 2.64 and −6.45 cm for girls and boys, respectively. Conclusion: There is more hamstring excursion in younger children than in older ones, and the hamstring excursion values reduce with age. It is also observed that hamstring excursion is more in girls than boys.

345

RESEARCH ARTICLE

Vaseem Shaikh, Ravimohan S Mavuduru, Aditya P Sharma, Girdhar S Bora, Nandita Kakkar, Shrawan K Singh

To Study the Quality of Life in Patients with Prostate Cancer

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:5] [Pages No:65 - 69]

Keywords: Prostate cancer, Quality of life, Treatment completion

   DOI: 10.5005/jp-journals-10028-1605  |  Open Access |  How to cite  | 

Abstract

Introduction: Prostate cancer (PCa) remains one of the most common causes of cancer deaths in men worldwide. While PCa can be deadly, 93% of men diagnosed will survive for at least 5 years, and 72.1% will survive for at least 10 years. Due to slow-growing nature of PCa, the life span of PCa patients is long. The longer the life span, the longer the time patients have to deal with disease and treatment-related side effects. The functional assessment of cancer therapy-prostate (FACT-P) questionnaire is a validated questionnaire for the evaluation of the quality of life (QOL) in PCa. We studied the QOL using a FACT-P questionnaire in different stages of PCa in an Indian setup. Materials and methods: This was a prospective observational study. Patients with carcinoma prostate at various stages of presentation were included over a period of 18 months. Patients were assessed with the FACT-P questionnaire in the form of an interview where questions were read, and responses from the patients were recorded. The interview was conducted both before and at least 3 months after the initial definitive treatment of management. The trial outcome index (TOI), functional assessment of cancer therapy-general (FACT-G), and FACT-P composite scores were calculated from the patient responses for various intragroup and intergroup comparisons. The localized prostate cancer (LCaP) cohort was subgrouped into low-risk (LR), intermediate-risk (IR), and high-risk (HR) groups as per DAmico risk stratification. The metastatic patient cohort was subgrouped into oligo and non-oligometastatic groups. Results: We included 63 patients with 26 LCaP, 10 locally advanced (LACaP), and 27 metastatic (MCaP). There were statistically significant differences in all three QOL indices, namely TOI, FACT-G, and FACT-P, before and 3 months after definitive therapy in all three stage categories. There were no differences in the QOL indices before treatment, in LCaP and LACaP, while the QOL indices differed significantly across all other intergroup comparisons, namely LCaP vs LACaP after treatment, LACaP vs MCaP both before and after treatment, and LCaP vs MCaP both before and after treatment. There were differences in TOI, FACT-G, and FACT-P scores before and after treatment in all the Gleason's grade groups (GG). Post hoc analysis showed that the differences were primarily between the GG-I and GG-V in both before and after treatment phases. Subgroup analysis showed a significant change in QOL scores in IR, HR, and oligo and non-oligometastasis groups 3 months after treatment. On post hoc analysis, it was found that the LR and LCaP patients had significantly better QOL indices than the HR before the LCaP treatment phase. The rest of the intergroup comparisons were not significant. Conclusion: We conclude that QOL in patients of PCa significantly improves with treatment at all stages of the disease, although it is poor in higher stages and grade at presentation. A larger cohort with a longer follow-up is needed to validate our findings.

290

RESEARCH ARTICLE

Tanvi Jha, Saloni Dagar, Preeti Diwaker

Impact of Coronavirus Disease 2019 on Postgraduate Training: Comparison of Dedicated and Nondedicated Coronavirus Disease 2019 Centers

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:9] [Pages No:70 - 78]

Keywords: Coronavirus disease 2019, Medical education, Novel coronavirus, Pandemic, Postgraduate training

   DOI: 10.5005/jp-journals-10028-1611  |  Open Access |  How to cite  | 

Abstract

Background: Postgraduate (PG) residents receive most of their training “on the job.” As coronavirus disease 2019 (COVID-19) became the singular focus, changes were made in healthcare delivery that had a wide-ranging impact on the education of PG residents. In this study, we aimed to evaluate and compare the perception of PG residents of dedicated and nondedicated COVID-19 care centers towards the effects of the COVID-19 pandemic on their own educational environment. Methods: A 13-item, pretested questionnaire was used. A total of 267 PG residents from two dedicated and two nondedicated government COVID-19 centers voluntarily participated in the study. Data were analyzed using Statistical Package for the Social Sciences (SPSS) v23. Results: Out of 267 residents, 96.6% felt that the pandemic had affected their training and this perception was significantly higher (p = 0.018) amongst those working in dedicated COVID-19 facilities. Decreased motivation, poorer attention span, fewer learning opportunities relevant to their branch, irregular online teaching, absence of practical training, increased workload, and inability to learn from and interact with their seniors and faculty are some of the other problems identified. Only 6% of residents believed that they were adequately trained for their professional career postresidency and about 66.7% of residents felt the need to repeat their residency as they felt undertrained. Conclusion: In view of the protracted nature of the pandemic, there is an urgent need to address the concerns of PG residents and come up with innovative solutions to problems identified in their training so as to ensure a timely well-prepared batch of PG without lowering the standard of medical education.

170

RESEARCH ARTICLE

Sai C Reddy, Sanjana Kathiravan, Shubh M Singh

An Analysis of Self-reported Long COVID-19 Symptoms on Twitter

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:3] [Pages No:79 - 81]

Keywords: Coronavirus disease 2019, Long coronavirus disease 2019, Long-hauler, Persistent symptoms, Twitter analysis

   DOI: 10.5005/jp-journals-10028-1616  |  Open Access |  How to cite  | 

Abstract

Objectives: A majority of patients suffering from acute coronavirus disease 2019 (COVID-19) are expected to recover symptomatically and functionally. However, there are reports that some people continue to experience symptoms even beyond the stage of acute infection. This phenomenon has been called long COVID-19. This study attempted to analyze symptoms reported by users on Twitter self-identifying as long COVID-19. Materials and methods: The search was carried out using the Twitter public streaming application programming interface using a relevant search term. Analysis and results: We could identify 89 users with usable data in the tweets posted by them. Most users described multiple symptoms, the most common of which were fatigue, shortness of breath, pain, and brain fog/concentration difficulties. The most common course of symptoms was episodic. Conclusion: Given the public health importance of this issue, the study suggests that there is a need to better study postacute COVID-19 symptoms.

259

RESEARCH ARTICLE

Nishat Akhtar, Sufiya Akhtar, Amina Kuraishy, Manazir Ali

Low-dose Magnesium Sulfate Therapy in Severe Preeclampsia and Eclampsia: A Safe and Effective Regime

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:6] [Pages No:82 - 87]

Keywords: Eclampsia, Magnesium sulfate, Preeclampsia, Recurrent convulsion

   DOI: 10.5005/jp-journals-10028-1620  |  Open Access |  How to cite  | 

Abstract

Introduction: Preeclampsia and eclampsia are life-threatening emergencies and require immediate management to decrease maternal morbidity and mortality. Magnesium sulfate (MgSO4) is primarily used in the treatment. To overcome the problem of toxicity, studies have been conducted to determine the lowest effective and safe dose of MgSO4. Methodology: The study was a randomized controlled study, conducted on pregnant women diagnosed with severe preeclampsia and eclampsia in Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India from September 2015 to November 2017. A total of 260 cases were randomly allocated into very-low-dose (0.5 gm/hour), low-dose (0.75 gm/hour), and standard-dose groups (1 gm/hour). Maternal and perinatal outcomes were noted, and statistical analysis was done. Results: Maternal and perinatal outcomes were comparable in all three groups. Recurrent convulsion rates in very-low-dose, low-dose, and standard-dose groups were 13.7, 5.4, and 14.2%, respectively. The amount of drug used in the very low-dose (0.5 gm/hour) was 42.6% less than the standard dose (1.0 gm/hour) and 25% less than the low-dose group (0.75 gm/hour). The results were highly significant (p ≤ 0.001) in both cases on statistical analysis. Conclusion: Low-dose of MgSO4 was found to be effective in controlling convulsions with less toxicity and complication rate.

619

SHORT COMMUNICATION

Arvind Nath

A Study of Malaria in Chandigarh

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:2] [Pages No:88 - 89]

   DOI: 10.5005/jp-journals-10028-1612  |  Open Access |  How to cite  | 

309

STATISTICS CORNER

Kamal Kishore, Vidushi Jaswal

Statistics Corner: Paired Groups

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:4] [Pages No:90 - 93]

Keywords: Chi-squared test, Statistical analysis, Wilcoxon–Mann–Whitney test

   DOI: 10.5005/jp-journals-10028-1626  |  Open Access |  How to cite  | 

Abstract

Health researchers frequently assess changes in patients’ disease status after giving interventions. Routine independent tests, such as t-tests (continuous outcome), Wilcoxon–Mann–Whitney (nonnormal continuous or ordinal outcome), or Chi-square (nominal outcome), will not be applied here. There are different statistical techniques to analyze data from paired observations. A researcher designed a pre–post study and collected data consisting of continuous and categorical variables. The literature search recommends applying paired t-tests for continuous data. However, the researcher is confused as data is not normally distributed when the normality assumption is assessed for pre and postgroup—the difference (post–pre) is normally distributed. Researchers, therefore, have a few vital questions related to the testing of paired data. What are the assumptions of paired t-tests? What test to apply for ordinal paired data? What test to apply for nominal paired data? What are the null and alternative hypotheses (H1) for paired data?

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CPC CLINICOPATHOLOGICAL CONFERENCE REPORT

Nishtha Ahuja, Parminder S Ottal, Nidhi Prabhakar, Ashutosh Aggarhwal, Sanjay Jain

Chronic Rheumatic Heart Disease with Infective Endocarditis in a 62-year-old Female Masquerading as Chronic Obstructive Airway Disease

[Year:2023] [Month:April-June] [Volume:57] [Number:2] [Pages:10] [Pages No:94 - 103]

   DOI: 10.5005/jp-journals-10028-1625  |  Open Access |  How to cite  | 

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