Journal of Global Medical Education and Research

Background: Janu Sandhigatavata, a Vata-predominant degenerative disorder of the knee joint described in Ayurvedic classical texts, corresponds closely to knee Osteoarthritis (OA) in contemporary medicine. Knee OA is the second commonest musculoskeletal problem worldwide, with a prevalence of 22–39% in India, predominantly affecting the elderly female population.16 Objective: To evaluate the efficacy of Marma Tantra — an ancient Ayurvedic therapeutic technique targeting vital energy points — in pain management and functional improvement in patients with Janu andhigatavata/Knee Osteoarthritis. Materials and Methods: An observational pre-test, post-test study was conducted on 20 patients (mean age 53.3 ± 6.95 years) fulfilling the diagnostic criteria for Janu Sandhigatavata at DGM Ayurvedic Hospital, Gadag. Marmatantra was administered over 7 sessions (1 week), combining Snehan with Ashwagandha taila, Mardan karma, Peedana karma, and Janu Marma stimulation. Outcome measures included Janu Sandhi Shoola (pain grading), Sandhi Shotha (swelling), Sandhi Atopa (crepitation), Sparsha Asahatva (tenderness), Walking Time, Visual Analogue Scale (VAS), WOMAC Scale, and Kellgren-Lawrence radiographic grading. Results: All parameters showed statistically highly significant improvement (p < 0.00001) after one week of Marma Tantra. Mean VAS score reduced from 2.7 ± 1.1 to 0.5 ± 1.4 (p < 0.00001). Mean WOMAC score reduced from 3.9 ± 10.8 to 2.1 ± 9.3 (p < 0.00001). Mean knee flexion improved from 100.5° ± 15.4° to 120.3° ± 10.1° (p < 0.01). Sandhi Shotha showed significance at p = 0.0075.

Surgical education relies heavily on textbooks, yet operating room realities reveal critical gaps in practical application, decision-making, and medico-legal compliance under India’s new criminal laws (BNS, BNSS, BSA 2023). This interview-based review captures reflections from an experienced surgeon on common procedures appendectomy, cholecystectomy, hernia repair, and trauma laparotomy highlighting experiential lessons in tNumber handling, complications, and clinical bedside documentation. Emphasis falls on BNSS §183 (mandatory videography) and §176A (viscera protocols), transforming surgeons into evidentiary stewards. Comparative tables juxtapose textbook ideals against practice realities, advocating simulationintegrated curricula to minimize litigation risks and enhance outcomes. These insights equip trainees for the art-science-humanity triad of surgery. Medical education provides a strong scientific and clinical foundation; however, the realities of medical practice often reveal important gaps between what is taught during undergraduate and postgraduate training and what is required for effective, compassionate patient care in practice. Drawing on reflections from a lifetime of surgical practice in India, this article examines two broad domains of learning: aspects of medical training that later prove inadequate or incomplete, and the essential professional competencies that are rarely taught but gradually acquired through experience. These include managing atypical clinical presentations, decision-making under uncertainty, caring for patients with multiple comorbidities, effective ommunication, expectation management, documentation, ethical dilemmas, grievance redressal, teamwork, and emotional resilience. Through illustrative clinical anecdotes, the interview dialogue highlights the “unwritten curriculum” of medicine that shapes doctors long after formal education ends. Recognising and integrating these lessons into medical training may help prepare future generations of Indian doctors to be not only clinically competent but also ethically grounded, communicatively skilled, and better equipped to navigate the complexities of contemporary medical practice.

The inclusion of health care services under the Consumer Protection Act (CPA) through the landmark V.P. Shantha judgment (1995) fundamentally altered the ethos of medical practice in India. By reclassifying patients as consumers and doctors as service providers, the judgment transformed the fiduciary doctor–patient relationship into a contractual and commercial one. This shift has fostered defensive medicine, excessive reliance on documentation and technology, and fragmentation of care into specialties and super-specialties. While the CPA strengthened patient rights and accountability, it also created inequities, eroded holistic healing, and burdened practitioners with litigation risks. This paper critically examines the judicial and medical consequences of CPA inclusion, highlighting the resulting “cauldron of chaos” in Indian health care, and proposes legal, institutional, and ethical safeguards to restore balance between accountability and compassion.

Breastfeeding is globally recognized as the optimal method for infant nutrition, providing significant health benefits for both the newborn and the mother. Despite the proven clinical advantages, global breastfeeding initiation and continuation rates remain suboptimal. Knowledge acquired during the antenatal period is a critical determinant of successful breastfeeding practices. This study aimed to assess the knowledge levels of antenatal mothers regarding breastfeeding and to identify potential gaps in their understanding. Employing a descriptive cross-sectional design, data were collected from 200 pregnant women attending antenatal clinics through a structured questionnaire. Results indicated that while awareness of the benefits of breastfeeding was high, specific knowledge regarding the management of common breastfeeding challenges, the duration of exclusive breastfeeding, and proper latching techniques was statistically insufficient. The study concludes that antenatal education programs must transition from general awareness campaigns to skill-based, targeted interventions.