Indian Journal of Medical and Health Sciences

This review article describes and analyses ethical issues in medical practice, particularly those issues encountered by physicians in their relationships with their patients. These relationships often involve ethical conflicts between 2 or more interests, which physicians need to recognize and resolve. The article deals with 4 topics in clinical practice in which ethical conflicts occur: physicians’ duty of confidentiality in a digital environment, their responsibilities for dealing with abuses of the human rights of patients, their role in clinical research, and their relationships with commercial enterprises. The ethical policies of the World Medical Association provide the basis for determining appropriate physician conduct on these matters. The article concludes with reflections on the need for international standards of medical ethics.

Keywords: Medical ethics; Physician patient relationship; Research ethics, World medical association.

The advent of liver diseases globally contributes to a major burden in terms of mortality rate and disease factor. The liver, which is a major complex organ, plays a vital role in the metabolism of the body. The diseases associated with the consumption of alcohol such as cirrhosis and cancer that can be diagnosed through various pathological and cytopathological methods. This review insights how the normally functioning liver cells become vulnerable and lead to the onset of various fatal disorders if left untreated. The alcohol, unlike other drinks, is directly absorbed from the stomach into the bloodstream and is further metabolized by the hepatocytes. The products of alcohol breakdown, such as aldehyde, are toxic to hepatocytes and thus cause liver injury, in cases of chronic alcohol consumption. This injury to the hepatocytes evolves over time and leads to liver cirrhosis. The only cure for severe liver cirrhosis is a transplant of the liver. On the whole, the widespread consumption of alcohol, its making, and effects on the hepatocytes on chronic consumption, which leads to alcoholic liver diseases reviewed.

Keywords: Hepatocytes; Fibrosis; Cirrhosis; Hepatitis, Hemochromatosis.

There is growing public awareness regarding the ethical conduct of medical practitioners and complaints against physicians appear to be increasing. Changing doctor-patient relationship and commercialization of modern medical practice has affected medical practice. Objective: To assess the knowledge and attitudes towards medical ethics among doctors in a Teaching Medical College, Hospital. Study design: Observational descriptive study. Material and methods: A self-administered structured questionnaire was distributed to all doctors in a Teaching Medical College, Hospital, a total 110 practitioners of various clinical departments participated. Result: 90% of the total participants were well aware about medico legal cases. All the participants doing ethical practice out of them 12% practice as per the demand of the situation. Dichotomy should not be a part of medical practice expressed by 88% of participants. Awareness regarding MCI code of medical ethics 2002 shown by 52% of respondents and 57% knows the role of ethical committee in their institute. Majority, 88% of them expressed that 15 days duty in the department of Forensic Medicine should be mandatory during internship to handle the medicolegal cases properly.

Key Words: Medical Ethics; Medico Legal Cases; Medical negligence

Background: High blood pressure follows the Iceberg phenomenon as it is one of the major causes of morbidity and mortality worldwide. Though hypertension is a problem of adults the etiologic process and risk behaviors start early in life3. Methods: An interventional study conducted on college students of DVVPF medical college. (table 2) Written informed consent was obtained from the participants who were the students of the age group 17-19 yrs and were included in the study. given in (table 1) Assessment of knowledge of students about hypertension and also its preventive measures was assessed by a pre-designed, and semi-structured questionnaire. Now after the study knowledge of students was checked. Results: Educational intervention helped increase the base knowledge of students about the normal range of blood pressure, Hypertension as a disease, its risk factors, and signs and symptoms. General awareness of the students about preventive measures of hypertension like avoiding junk food/ healthy diet, exercise, and meditation was 26%, 29%, and 6% respectively which was significantly increased after the educational intervention.(table 3) Conclusions: Attempts should be made towards educating college students about hypertension so that they change their lifestyles and reduce the incidence of hypertension in later life.

Keywords: Blood Pressure; Adolescents; Hypertension; Prehypertension.

Background: Since World Health Organization declared H1N1 (Swine flu) a pandemic disease on April 29, 2009, it is continuing to be a major public health problem and it has significant regional and seasonal variation. Therefore, this study was planned to evaluate epidemiology, clinical profile, course of illness and their outcome. Material and Method: Present prospective crosssectional study was conducted on RT-PCR confirmed cases of swine flu admitted in dedicated swine flu ward in the Department of Medicine, S.P. Medical College & Associated Group of P.B.M. Hospitals, Bikaner. All patients were subjected to detailed clinical examination and relevant investigation as per proforma. Clinical and epidemiological data were collected. All patients subjected for routine lab examination including complete blood count, renal function test, liver function test, fasting blood sugar, ABG, X-ray chest PA view and other specific investigation as per requirement. Result: Most females belonged to age group 18-35 years and most of the malesbelonged to age group >55 years. Most of cases belonged to category C (62%) and urban residential area (55.7%). Most common symptom was cough (98.7%) followed by fever (91.1%), sore throat (86.1%), sputum (83.5%), nasal discharge (73.4%), breathlessness (72.2%), headache (58.2%), chest pain (27.8%) and palpitation (16.5%). Our study shows multiple organ involvement during the course of swine flu as indicated by increasing blood urea (36.7%), serum direct bilirubin (19%), serum creatinine (18.9%), SGOT (68.3%), SGPT (37.8%) and decreasing serum albumin (63.3%). Overall mortality rate in our study was 8.8%.It was high in females (9.1%) as compare to males(8.6%).All deceased belonged to category C and cough was the most common presenting symptom followed by sore throat, nasal discharge, sputum and fever. Conclusion: Our study shows there are certain factors which can affect outcome in the cases of swine flu. Female gender, elderly age, co morbidity and the duration of illness(6-10 days) are the important factors associated with poor outcome. Early recognition and alertness is important to reduce morbidity and mortality. Patients should also be screened for multiple organ involvement at the time of hospitalization by laboratory test like CBC, RFT, LFT for early diagnosis of multiple organ involvement so as to treat appropriately to prevent multiple organ failure and mortality.

Keywords: RT-PCR; Swine Influenza; Multiple Organ Failure.