Indian Journal of Medical and Health Sciences

Pressure sores are the common problems faced by the health care personnel and the family members of critically ill patients. They cause significant burden for the health care system. Even though pressure is the main reason, the etiology is multifactorial. And the patients affected usually will have other associated co-morbidities. Hence systematic approach for the management of pressure sores is necessary for obtaining the better result. SWCR guidelines for wound management are one of the guidelines for manage the chronic wounds. This study highlights the experience of managing pressure sore using SWCR guidelines.

Keywords: Pressure Sores; SWCR Guidelines. 

Sometimes Diet and exercise is not much effective for people with extreme and excessive obesity. Bariatric surgery helps such individuals to reduce their weight. Bariatric procedures cause weight loss by restricting the amount of food the stomach can hold, causing malabsorption of nutrients, or by a combination of both gastric restriction and malabsorption. After bariatric surgery eating patterns of patient changes. Initially after surgery the main goal is to meet fluid and protein needs from a liquid protein diet. As the diet progresses to variety of foods which are low in sugar and fat, it will meet the nutrition needs better for long term health. It is vital to follow diet progression to maximize healing and minimize risk for complications. This review recapitulates the present protocol for nutrition care in bariatric patients to escalate safe practice in preoperative and long-term postoperative periods

Keywords: Obesity; Bariatric Surgery; Nutrition; Eating Pattern; Diet Progression. 

Telemedicine enables health services to be connected across distance by the use of information and communication technology. Role of telemedicine on emergency services has a great impact on health services. JIPMER has developed 24x7 Help Line in Casualty for patients requiring Tele-Emergency Consultations. Teleconsultation is given to people who seek medical advice and guided for future treatment based on their complaints. Use of this service helps the patient in terms of cost and time and enables them to get specialist consultation if needed in real time. From our experience, use of telemedicine through dial JIPMER service has been satisfactory for both the patient and the Doctors and can be further extended to other institutions

Keywords: Telemedicine; Teleconsultation; Dial-Jipmer. 

Sepsis is one of the most common causes of death worldwide both in hospitalized and non hospitalized patients. Vitek 2 is an automated system used for identification of bacterial isolates. These automated systems in bacteriology are very important for rapid and accurate detection of bacterias for effective diagnosis and treatment. Vitek 2 identified 18 genera of bacterias, 40 up to species level and 4 up to subspecies level. A total of 299 blood culture were tested, most common organism were gram negative bacteria (fermenters) followed by nonfermenters, gram-positive cocci and some of the bacterias which were isolated were uncommon and not detected by routine culture techniques. This retrospective study was carried out in order to study the incidence of bacterias isolated from blood cultures by Vitek 2.

Keywords: Vitek 2; Sepsis; Bacterias. 

Background: Sexual history taking (SHT) for instance is described as an important clinical skill that formal medical school curricula have historically neglected. However, such skill deficit might not be overcome even after graduation. The deficiency in learning SHT skills might eventually affect students’ career choices. Aim: To assess the difficulties faced by undergraduate medical students while eliciting sexual history and to identify the pitfalls and the students preferences in the teaching learning methods for taking sexual history perceived by the students. Methodology: A cross-sectional study was conducted in our medical college hospital between Jan 2016 and June 2016 involving the students of final year medical students and CRRI’S. Total numbers of participants were 220 students. Questions related to their comfort and confident level in eliciting sexual history along with general history, prerequisites in obtaining sexual history and the ideal age and gender according to the students perception was all obtained in the questionnaire. Questions for assessing the barriers in eliciting sexual history among the medical student’s and the current teaching methods which were followed for obtaining the sexual history was obtained. Likerts scale was used for assessing the student’s attitude towards asking the sexual history. Finally suggestions were also asked in improving the teaching methods for obtaining the sexual history. Results: The CRRI’s were found to be more confident in eliciting sexual history than the final year MBBS students, as they had one more additional year of exposure and females in both the groups were found to be slightly more confident than the males in eliciting the sexual history. Most of the students in both the groups felt that cultural and religious differences are the major barriers in eliciting the sexual history and they were also able to recognise their own limitations. Majority of the students agree to the point that they had not been adequately trained in eliciting sexual history. Students felt that they have to be taught by means of role play, video clips and simulated patients which would practically guide them in eliciting sexual history to the patient in a much more skilful and confident manner. Conclusions: Lack of confidence in approaching the subject of sexual health, inadequate preparation were some of the barriers identified. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take a sexual history from patients.

Keywords: Under Graduate Medical College Students; Sexual History Taking; Teaching Learning Methods. 

Overweight refers to an excess body weight compared to set standards. Obesity specially refers to having an abnormally high proportion of total body fat. Most health providers agree that men with more than 25% total body fat and women with more than 30% total body fat should be considered obese [1]. A more important aspect of obesity is the regional distribution of excess body fat. Our research is a prevalence study to find out the distribution of obese and overweight girls from two different communities distributing them according to different anthropometric parameters. The 1001 girls residing in different hostels from different colleges were selected for the study. Two groups were made and the total girls were categorized into Gujarati and Non Gujarati groups respectively. They were further classified according to categories like waist circumference, hip circumference, waist hip ratio, obesity indices, body fat percent, total body fat, lean body mass, skinfold thickness, family history and blood pressure. Fourteen percent were overweight and eleven percent girls were obese according to waist circumference. Seventy one percent had hip circumference of more than 36 inches; waist hip ratio of more than 0.85 was observed in 47% girls; Twenty four percent had high waist circumference, waist hip ratio and BMI>25 kg/m2; Eighty percent had body fat percent < 33%, 27% had total body fat > 20 kg; Fifty six percent had lean body mass > 42 kg and sixty nine percent had skinfold thickness > 50 mm. Seventy eight percent girls were without any family history of disease and 53%/46% had high normal systolic and diastolic blood pressure.

Keywords: Prevalence; Obesity; Anthropometry; Indices of Obesity. 

The prevalence of Tuberculous meningitis is increasing in developing countries including in India. Many complications, long term sequelae and deaths are associated with tuberculous meningitis. Our aim is to access the complication in different stages of tuberculous meningitis and to identify the predictors of mortality. Method This prospective study was conducted in tertiary care hospital, Eastern India from (May2013- June 2016). Study included patients suffering from tuberculous meningitis proved by history, clinical examination, CSF study and radiological imaging. The patients were then classified according to different stages of tuberculous meningitis and observed for the complications including seizures and drug induced hepatitis and mortality differed between the three stages. All the patients were put on treatment and followed up. Result A total of 100 cases were enrolled in which 54 were males and 46 females with median age 29.2+11.15 years. 36%, 37% and 27% of patients presented in stage I stage II and stage III respectively. 46% developed hydrocephalus, 29% had cranial nerve palsy, 24% had stroke, 23% had seizures, 17% developed tuberculoma, 13% had hypodensities suggestive of vasculities and basal exudates were seen in 33%. 17 patients were died during hospital stay and 83 patients were discharged. Conclusion our study showed the disease is more prevalent in younger population equally affected males and female. The rate of central nervous system complication is high every complication contributes to morbidity and mortality but the greatest predictors are seizure, stroke, drug induced hepatitis and advanced stage of disease.

Keywords: Tubercular Meningitis; Seizures; Hepatotoxicity. 

Pressure sores are unyielding wounds proving a nightmare to treating physician and adding to financial burden and psychological distress of the patient and the care giver. Systemic multidisciplinary approach and multimodal intervention to treat the wound is essential to achieve favourable results. In our case report we highlight the various modalities of treatment that can be used for the treatment of such pressure sore and review other modalities that can be used to accelerate the wound healing process.

Keyword: Pressure Sore; Autologus Platelet Rich Plasma; External Tissue Expansion; Negative Pressure Wound Therapy.