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  Most popular articles (Since August 31, 2020)

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Exceptions of diffusion of innovation theory during COVID-19 pandemic and health policy implications - A viewpoint
Sudip Bhattacharya, Harmehr Sekhon, Neha Sharma, Amarjeet Singh
September-December 2020, 1(1):3-7
Diffusion of Innovation expedites the health promotion through enhancement in behaviour changes. If the natural course is uninterrupted the DOI theory follows the normal curve but if dissemination component is supplemented with this, it can bring about change in the normal curve with faster adoption rate by the society. This new way of adoption will not only benefit the adopters but guide public health experts, policy makers and implementers amidst pandemic crises like COVID-19. Thus, the theory of dissemination should be clubbed with DOI theory for formulating any health policy for any country.
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Characteristics of mechanical bony block at the elbow region following noncompliant treatment in rural settings: A retrospective study from a teaching hospital
Ganesh Singh Dharmshaktu
January-April 2021, 2(1):10-13
Background: Elbow function is important for activities of daily living and restriction of its full range of motion affects the quality of life. Various localized reasons such as trauma, congenital deformities, and diseases may alter bony anatomy resulting in suboptimal joint movement and require appropriate diagnosis and subsequent management. It is therefore important to know the common causes of mechanical elbow block and their pattern. Materials and Methods: A retrospective account of serial cases of mechanical flexion block with the radiological presence of bony hindrance to elbow motion were included with relevant characteristics like patient demographics, laterality, reason, anatomical involvement, previous and further treatment were noted for each of them. Result: A total of 21 cases (18 males and 3 females) with mechanical flexion block were part of the study with a mean age of 20.19 years. Malunited supracondylar and malunited radial head fractures were commonly identified the reason for the bony block, followed by other singular causes. Operative intervention was done in most of the cases, while one case was managed conservatively. Lack of availability of specialist doctors, lack of regular transport to higher center, and financial issues were reasons behind noncompliance to the treatment. Conclusion: Mechanical motion block is disabling condition and dedicated preventive and therapeutic intervention is required to deal with it. The pediatric cases can be observed for remodeling failing which operative intervention can be done. The surgery in selective adult cases leads to good outcome.
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Infectious disease transmission through touch-enabled biometric system: A digital dilemma
Sudip Bhattacharya, Md Mahbub Hossain
January-April 2021, 2(1):5-9
We use biometrics to authenticate the identity of humans by their behavioral or physiological features. Due to the digital revolution in India, the biometric technology is penetrating its roots in the health care (in the primary, secondary, and tertiary care levels) and other industries at a rapid pace. As an example, “Aadhaar-enabled Biometric Devices” have already acquired a lot of appreciation, after the successful implementation of “Ayushman Bharat Yojana” in India. However, during the COVID-19, pandemic, many institutes banned biometric attendance of their employees, due to the fear of infection transmission. The current paper aimed to describe the potential of infection spread through touch-enabled biometric devices and discussed the control measures to limit the spread of infectious diseases. A literature search was done using “PubMed,” “Google Scholar,” and “Scopus” databases for the key terms “biometric,” “infectious diseases and biometrics,” “infection and touch enabled biometrics,” and/or “touch enabled sensors”. All the relevant articles were included to support the argument for this narrative review. Commonly biometric systems use two types of sensors one is contactless, and another system requires direct contact to authenticate human beings. To authenticate by the biometrics (touchable), the end user must make direct physical contact for some time. It may increase the possibility of contamination with contagious/infectious agents (by food and water) to its subsequent users. Later, this event raises the chances of inoculation of dangerous contagions into our airway, and this is one of the ways, how infectious disease transmission occurs. To prevent infectious disease transmission, a multimodal confirmation system having the option for added means of authentication, like a spoken codeword or token or traditional methods like written attendance can be deployed within the organizations/healthcare facilities/medical colleges. To conclude, this paper proposes the adoption of a multimodal approach to prevent transmission of infectious diseases through fingerprint scanners.
  3,093 199 -
Infantile colic in exclusive breast feed babies: A clinical dilemma
Nishantadeb Ghatak, Sheikh Mohd Saleem, Sudip Bhattacharya
May-August 2021, 2(2):32-33
Many newborns and infants on exclusive breastfeeding who appear to be healthy report to the emergency room with a sudden start of intense intermittent crying lasting 2-3 days with no obvious clinical explanation. They may also have moderate gaseous distension of the abdomen, abdominal wall contractions, and the refusal to sip their mothers' milk on occasion. Because the onset is rapid and is linked with abdominal distension, a surgical aetiology is frequently explored. Because vomiting is almost never present, the potential of obstruction is ruled out. Even so, an ultra-sonogram is frequently performed to rule out surgical causes of intermittent intussusception. What should be done in this situation? It is necessary to obtain a complete food history from the mother. Surprisingly, in clinical practice, almost all of these instances have a history of the mother eating chicken, mutton, or another spicy food within 24–48 hours after the onset of these atypical symptoms. Around the world, different societies have distinct dietary restrictions for nursing women. Caffeine, spicy meals, raw foods, cold foods, and sikhye are the most commonly self-restricted foods among Korean women. Cold, hot, and spicy meals are traditionally suggested to Asian moms to avoid because they are bad for both the mother and the infant. Similarly, foods such as pork, green chilies, and tomatoes are prohibited among Hispanic mothers despite the lack of supporting evidence. According to the research, maternal dietary components are eliminated in breast milk, either partially or completely. Some are well tolerated, while others cause GI intolerance or allergic reactions in the newborns gastrointestinal tract. Breastfeeding intolerance is characterised by abdominal bloating, colic, indigestion, and a change in stool colour, texture, and odour. More evidence-based study on this topic is needed, and it should be done briefly to help parents relieve their anxiety and save out-of-pocket medical expenses by ruling out surgical causes or emergency hospital visits or admissions.
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Burden of cases with large joints bony ankylosis following open injuries in rural region: A hospital based cross-Sectional observation
Ganesh Singh Dharmshaktu
September-December 2020, 1(1):12-15
Background: Normal large joint anatomy is important for mobility, function and overall quality of life. Trauma or diseases like various forms of arthritis may alter normal joint architecture and physiology leading to secondary arthritis. Infection within the joint leading to septic arthritis is another catastrophic disorder that may irreversibly damage the human articular cartilage. The resultant bony ankylosis in certain cases is a serious complication of septic arthritis. There has been limited data regarding the burden of people living with post-infective ankylosis of one or more major joint and its other variables. Materials and Methods: Details of all consecutive cases coming to hospital out-patient department for the related or other complaints with one or more major joint found completely ankylosed in the radiographs were noted in separate file. The clinical complaints for which they present either related with the condition or other were also noted. Key demographic details like age, sex, laterality, history of causative factor, time living with the deformity, other co-morbidities were also recorded. The relevant details of the ankylosed joint following confirmation on radiographs were clinically confirmed with presence of no apparent movement of the affected joint. Results: A total of 21 (17 males and 3 females) patients with mean age of 32.1 years were part of the study. The ankle joint was most commonly involved followed by hip, knee and elbow in 13, 6, 2 and 1 case respectively. Our study attempts to know the burden of people living with ankylosed joint as a result of open injuries in the past. Conclusion: Relevant demographic data and the type of joint involvement in adults living in rural areas with one or more major ankylosed joints shall help draft preventive and treatment strategy in this regard.
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Call for strengthening rural healthcare services: Blending rural practice, medical care and surgical specialties
Raman Kumar
September-December 2020, 1(1):1-2
Rural habitat poses several disadvantages to the rural population. Challenges are immense when it comes to organizing the provision of general medical and healthcare services to rural communities. Rural communities are sparingly populated and often remotely located in difficult terrains. Organizing healthcare services such as location is not only difficult logistically but also an expensive proposition. Services are generally planned according to the population and density from the public health perspective. However, human needs are equal for rural people as compared to their urban counterparts. For the rural population to have access to necessary and quality healthcare; the services must be available and obtainable within the rural communities in the primary care setting.
  2,741 186 -
Survival rates among breast cancer patients from a hospital based cancer registry, Thrissur, Kerala, India
Rachel K Iype, Clint Vaz, Catherin Nisha
September-December 2020, 1(1):8-11
Introduction: Breast cancer is a biologically heterogeneous disease and patients with the same diagnostic and clinical prognostic profiles can have markedly different clinical outcomes. This difference is possibly caused by the limitation of our current taxonomy of breast cancers, which groups molecularly distinct diseases into clinical classes based mainly on morphology. Objectives: The study objective was to assess the survival rates of breast cancer patients of all immunohistochemical subtypes at a hospital-based cancer registry, Thrissur, Kerala. Materials and Methods: After obtaining Institutional Ethical Clearance we included 202 patients of histologically diagnosed breast carcinoma who had been diagnosed in the year 2016. Data was obtained from the patient files. Associations between tumor subtypes and survival rates were examined. Results: Of the 202 patients, 197 were females and 3 were males. The mean age of the study population was 55.9 ± 11.8 years. The survival rate at three years was 76.5%. Conclusions: It was found that the survival rate at three years for the study population was 76.5%. Community-based surveys will give a better outlook regarding the survival rates in the general population. More studies from developing countries like India are appreciated to understand the burden of disease.
  2,663 175 -
Protecting Rural India from COVID-19: Second wave 2021
Raman Kumar
May-August 2021, 2(2):19-20
The population of India is 1.380 billion. Sixty-five percent of the Indian population lives in rural habitat. However, the healthcare facilities are largely concentrated in urban areas. The first peak of the COVID pandemic peaked in September 2020 gradually declining till mid-February 2021. Rural India has often travel to urban centers for treatment and disease management. The second wave started in March and peaked with a daily number ranging more than 400,000 till May 10th. It is now spreading into rural India. The culture of access to healthcare among rural populations is different from the urban areas. Facilities and infrastructure are also scarce as compared to the urban areas.
  2,579 154 2
Preventive geriatric care model: A dire necessity in recent times!
Nilanjana Ghosh, Dipankar Debnath
May-August 2021, 2(2):29-31
A holistic concept of providing regular health check-up, reinforcing their intent to a healthy and happy living, taking care of them with a day care center and communicating to their family members both in station and outstation every fortnight regarding their health status is the aim of the project. A benefit to community and forming a strong self-sustaining wise peer group who will turn into an asset than a liability for a community is the sole motto of the project. In the aforesaid context to create a geriatric-friendly society, this preventive geriatric care model was envisaged.
  2,573 147 -
Letrozole: The ovulogen of first choice
Mayoukh Kumar Chakraborty, Gautam Khastgir
January-April 2021, 2(1):1-4
  2,524 189 -
SnakeBite wound with open volar proximal interphalangeal joint dislocation of little toe: An uncommon rural case
Ganesh Singh Dharmshaktu
May-August 2021, 2(2):27-28
Snake-bite injuries are uncommon events but a significant number of cases are reported from rural areas. The basic principles of diagnosis and management of snake-bite injuries should be known to rural practitioners and prompt referral should be done in selected cases. The extremity bite may occasionally result in localized cellulitis and soft tissue infection that may complicate later into underlying bone invilement. Dislocation following the open wound in these setting is rare occurrence that needs proper knowledge for its diagnosis and management.
  2,507 162 -
Oral health management of children during coronavirus disease 2019 pandemic
Chaitali Hambire, Umesh Vishnu Hambire
May-August 2021, 2(2):21-26
Coronavirus disease 2019 pandemic has affected more than 200 countries worldwide. It has caused complete lockdown in most of the countries due to its highly contagious nature. Aerosol generated during dental treatment can be a major source of human-to-human transmission. Management of oral health of pediatric population should address emergency as well as nonemergency dental problems. This article attempts to provide possible approach on identification and management of emergency, urgent, and nonemergency dental conditions. It also suggests various preventive measures toward the maintenance of oral health and hygiene of children.
  2,448 192 -
Nonpharmacological intervention module for graded domiciliary care in dementia care at community level: A novel endeavor
Nilanjana Ghosh, Bhaskar Mukherjee, Avik Layek
September-December 2021, 2(3):39-41
Mental health is an oftly neglected topic more so due to stigma associated with the disease. Hence, availability of a user-friendly module can be of immense help to carers improving their mental health, as they often suffer from depression. This in turn may lead to clinical improvement of the patient as well. Integrating each family member into the care practices is also equally important. Nonpharmacological interventions once designed and structured will lead to a standardized care continuum at the community level for all patients and will help as a ready reckoner for the careers to compare their work or call out to each other during times of need. Even the burden on hospitals will decrease which will then mainly focus on patient monitoring pharmacological interventions.
  2,332 149 -
Comparison of knowledge, attitude, practices, and psychological impact of COVID-19 among the urban and rural population of Bangalore, Karnataka
Nuthan Bhat, Hiba Salam, Sushma Javvaji, Ananya Chakraborty
January-April 2022, 3(1):13-18
Context and Objectives: There is a strong urban-rural divide in India in terms of education, economic status, and availability of health care. This became more prominent during the COVID-19 pandemic. Hence, the government emphasized on preventive aspects, especially in terms of safety practices. With this context, this study sought to evaluate and compare the knowledge, attitudes, practices, and psychological impact of COVID-19 among the urban and rural population of Bangalore to study the differential effects on both communities. Materials and Methods: An online questionnaire was distributed to 142 participants between December 1 and 31, 2020. The goal was to receive responses from both urban and rural population of Bangalore. Informed consent was taken from all participants. The response scores were tabulated and analyzed using statistical software. Results and Conclusion: A total of 138 responses were evaluated. In comparison to the urban population, there was a statistically significant link between inferior education and occupation in the rural population. (P 0.001). There was a statistically significant difference between rural and urban respondents in terms of knowledge (P 0.001) and attitude (P 0.05). The rural population's COVID-19 practices and the psychological impact were shown to be worse, but this was not statistically significant. A holistic approach is required to increase the rural population's knowledge and practices to integrate them with the rest of the country and combat the COVID-19 pandemic more effectively.
  2,221 160 -
Perioperative management of coronavirus patient and critical care concerns
Nidhi Kaeley, Prakash Maha, Rohan Bhatia, Suman Choudhary
September-December 2021, 2(3):42-45
Coronavirus disease 2019 caused by SARS-COV-2 virus was first detected in China in December 2019. The World Health Organization declared it as a public health emergency of international concern on January 30, 2020. It is a beta coronavirus with identical genome as that of bat coronavirus hinting to bats as a natural host. It causes a wide spectrum of clinical symptoms. They include fever, dry cough, fatigue, loss of smell, diarrhea, and severe pneumonia leading to acute respiratory distress syndrome. The elderly population and those with underlying comorbidities are more prone to severe pneumonia and higher mortality. At present, India is in the stage 2 of local transmission of SARS-COV-2 infection. However, Indian government in collaboration with the Indian Council of Medical Research is taking stringent steps to prevent stage 3 transmission that is community spread. In this review article, we discuss evidence-based principles and guidelines of infection control and perioperative management of patients in COVID-19 times. The emphasis is on the use of personal protective equipment's and hand hygiene steps to prevent viral transmission by and to the anesthetist and other frontline health-care workers as well as patients.
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COVID: Team work and salutogenesis: A perspective
Nilanjana Ghosh, D Bandyopadhyay, Louis Tirkey, K Samajjdar
September-December 2021, 2(3):37-38
  2,163 187 -
Modalities and essentials of simulation facility for facilitation of clinical skills to medical and nursing students: Need for the present era
Rakesh Sharma, AS Vishwas, Prasuna Jelly, Lisa Chadha, Shine Stephen, Shalinee Rao
January-April 2022, 3(1):1-5
The use of simulation is a unique teaching–learning approach in medical and nursing education to empower undergraduates with desired clinical skills. Simulation duplicates the events from the real world and influences the learner in a naturalistic setup and evokes a real experience to the learner. This method of learning facilitates students to practice multiple times to attain proficiency in a particular technique without compromising on patient safety. They can rely on simulation exercises in clinical skill laboratories (CSL), which boost their confidence level, reduce anxiety, and promote satisfaction before performing or dealing in real clinical settings. Simulation has been widely used for formative evaluation and is a reliable assessment tool as it ensures a high level of objectivity. The simulation-based approach in undergraduate medical and nursing education is an effective way of learning that can be incorporated into the educational strategy. This article presents the evolutionary growth, modalities, prerequisites, usefulness, and challenges for simulation-based learning.
  2,197 147 1
Safe disposal of pins and wires removed from seropositive cases: An additional safety tip
Ganesh Singh Dharmshaktu
May-August 2021, 2(2):34-35
  2,161 131 -
Tackling nail injury in a primary care setting: A tricky turf
Nikita Sharma, Manish Kumar, Sanket Vashist
January-April 2022, 3(1):19-21
Toenails provide stability to the foot. A stubbed toe may result in nail injury or fracture. Toe injuries are often ignored, leading to inappropriate or delayed management. The COVID-19 pandemic has badly affected the health services leading to further delay in treatment. We present a case report of an adult male who presented with an injured toe at a primary care clinic in India. Due to the apprehension of contracting severe acute respiratory syndrome coronavirus 2 infection and lockdown restrictions, the patient neither wanted to go to a higher center or get investigations done. The case report discusses the management and ways to handle such cases for primary care doctors in a resource-constrained setting.
  2,049 106 -
“Sign of Horns” following sickle injury: An uncommon rural spot diagnosis
Ganesh Singh Dharmshaktu
September-December 2020, 1(1):16-17
  1,988 121 -
Inadvertent fall of oxygen cylinder on foot: An uncommon injury during oxygen crisis in COVID-19 wave
Navneet Adhikari, Ganesh Singh Dharmshaktu
September-December 2021, 2(3):46-47
Thirty two year old male presented to us with compliant of fall of an oxygen cylinder over his right great toe while transporting it. There were pain and swelling, for which he later contacted emergency room. Production and transport of oxygen were much-needed step that was palpable in the time of pandemic crisis. Amid the looming and potential oxygen crisis during COVID-19 pandemic, the need for self-sustained oxygen concentrator as safe, low-cost, and easily available solution was advocated for rural India.
  1,952 129 -
An alternative tool for muscle biopsy sample mounting for rural primary care center
Ganesh Singh Dharmshaktu
January-April 2021, 2(1):14-15
  1,905 163 -
Snake bites in Rural India - A surgical view point
Devang Srivastava, Sanmeet Singh, LV Simhachalam Kutikuppala, Tarun Kumar Suvvari
September-December 2021, 2(3):48-49
  1,783 164 -
Myiasis and extremity involvement: A concise update
Tariq Akhtar Ansari, Ganesh Singh Dharmshaktu
January-April 2022, 3(1):9-12
The human myiasis or infestation of larvae of various species of fly bots is uncommon but interesting health challenge in some parts of the world. The basic knowledge of this disease, however, should be beneficial to clinicians across disciplines as a spectrum of manifestations involving various organs are described in the medical literature. The extremity involvement is rather uncommon and is often found with underlying associated conditions. The diagnosis and identification of the causative species is important for documentation and management. Clinical suspicion, wound lavage, dressing, and debridement are important steps in optimal management. Appropriate systemic pharmacotherapy is supplemented for quick recovery. Prevention, however, coupled with avoidance of predisposing factors is the best management in both community and health-care settings. As the disease is more commonly noted in lower socioeconomic conditions and rural settings, the working knowledge of this condition should come in handy in anticipating, suspecting, and thus diagnosing the condition early for a prompt recovery.
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Liver injury among coronavirus disease patients
Tarika Sharma, Jitender Singh
January-April 2022, 3(1):6-8
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as Coronavirus disease 2019 (COVID-19), is a novel coronavirus first identified in December 2019 and has a broad spectrum of clinical presentations. With the expansion of related research, it was found that in addition to respiratory symptoms, digestive involvements and liver injury were reported among COVID-19 patients. Abnormal liver function was observed in cases of COVID-19, manifesting mainly as isolated elevated serum transaminase and lactate dehydrogenase levels. The current review highlights the possible explanation for liver injury among COVID-19 patients.
  1,802 133 -