Journal of the Indian Medical Association

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The Study of Thyroid Profile in Patients with Chronic Kidney Disease — A Hospital Based Observational Study
(Indian Medical Association, 2025-01) Nongtdu, Daemi; Das, Polok
Background : Chronic Kidney Disease encompasses a spectrum of different pathophysiologic processes associated with abnormal kidney function and a progressive decline in glomerular filtration rate. Materials and Methods : A hospital based observational study of one year duration was conducted in the Department of General Medicine, Silchar Medical College and Hospital with 100 Chronic Kidney Disease patients. The thyroid profile of the 100 patients with Chronic Kidney Disease patients was conducted . Results and Observation : Age ranges from 30-59 years which were sub-grouped into three age groups [30-39 years, 40-49 years,50-59 years]. Female patients were 52 in number constituting 52% whereas males were 48 in number constituting 48%. The study range of serum T3 is 11-171 ng/dl and the mean being 79.80 ng/dl (normal range is 80-180ng/dl ). In our study 65 patients had low T3 syndrome, 50 patients had low T4 syndrome and 3 patients had Hypothyroidism. Conclusion : As age increases the incidence of low T3 syndrome increases in our study. According to our study as age increases the severity of Chronic Kidney Diseases increases.
Assessing the Impact of CHA2DS2-VASc Score on Oral Anticoagulation Recommendations for Non-valvular Atrial Fibrillation Patients in the Indian Population
(Indian Medical Association, 2025-05) Pawar, S; Janorkar, S; Saner, AA; Jadhav, A; Gandhi, MA; Deshmukh, M; Arkar, R.
Background : Stroke is a major complication of Atrial Fibrillation (AF), often managed with oral anticoagulation to reduce associated morbidity and mortality. This study compares the CHADS2 and CHA2DS2-VASc scoring systems in guiding anticoagulation therapy in patients with Non-valvular Atrial Fibrillation (NVAF). Materials and Methods : A total of 87 NVAF patients from a Tertiary Care Center in Pune were evaluated using ECG and Echocardiography. CHADS2 and CHA2DS2-VASc scores were calculated and oral anticoagulation was initiated based on the CHA2DS2-VASc score. Follow-up was conducted at 3 and 6 months to assess compliance and bleeding events. Results : While CHADS2 recommended anticoagulation in 64% of patients, the CHA2DS2-VASc score increased this to 92%, reflecting a 28% higher identification rate. Eighty patients received oral anticoagulants. Discontinuation rates were 26% and 33% at 3 and 6 months, respectively. Minor bleeding was reported in 2.5% and 6% of patients at the same intervals. Conclusion : The CHA2DS2-VASc score offers more precise recommendations for anticoagulation in NVAF, identifying a higher number of patients at risk of Stroke compared to CHADS2.
A Case of Arrhythmogenic Right Ventricular Cardiomyopathy with Left Ventricular Involvement Presenting as Recurrent Ventricular Tachycardia
(Indian Medical Association, 2025-05) Chigullapalli, S; Sharma, V
Background : Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is condition of genetic inheritance. Pathologically characterized by fibrofatty replacement of cardiac muscle mainly in right ventricular myocardium. Ventricular arrhythmias of right ventricular origin may lead to sudden cardiac death in young adults and athletes. Usually, male patients with age less than 40 years present with recurrent palpitation later develop progressive right heart or biventricular failure. Here we report a case of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) with left ventricular involvement with recurrent ventricular tachycardia. Case Presentation : A 39-year-old male patient with no comorbidities presented with palpitations and giddiness. He was hemodynamically unstable and ECG showed ventricular tachycardia with Left Bundle Branch Black (LBBB) morphology. Patient was managed with cardioversion and anti arrhythmic drugs amiodarone and betablockers. His 2D echo and cardiac MRI done and diagnosis of arrhythmogenic right ventricular cardiomyopathy with left ventricular involvement was made based on 2020 international criteria. He was adviced Implantable Cardioverter-Defibrillator (ICD) implantation. As patient refused ICD implantation he was continued on amiodarone and beta blockers. Conclusions : ARVC is a rare disorder, and proper diagnosis is important to avoid unnecessary delay in managing the patients. 2020 International criteria helps to diagnose ARVC. Although ICD implantation is the treatment of choice for these patients, medical management with beta-blockers and amiodarone are helpful to prevent recurrent episodes of ventricular tachycardia in these patients.
Role of Interleukin-6 and Bells Adjustment Inventory Scoring in Evaluating Stress on Surgeons during Surgery
(Indian Medical Association, 2025-01) Veerendranath, Hariprasad Kanakapura; B L, Preethi
Background and Objectives : Stress is a major public health problem in our society and Health Care Workers are subject to high levels of stress at the workplace1. Interleukin-6 (IL-6) is a pleiotropic cytokine and has been shown to be stress responsive. Our objective was to evaluate IL-6 as a marker of stress in surgeons when measured before and after performing a surgery and corelate the same with their individual adjustment score using Bells Adjustment Inventory (BAI) questionnaire. Materials and Methods : In 40 Subjects were enrolled in our study, 20 surgeons and 20 of the study subjects in control group were non-health care workers performing clerical work. BAI questionnaire was administered to both groups and their morning blood sample collected and IL-6 measured as a baseline. In addition, surgeons blood sample was collected a second time after they performed a surgical procedure. Results : It was observed that IL-6 (pg/ml) levels at baseline in Surgeons was found to be higher in comparison to control subjects, possibly indicating higher stress levels among surgeons even at rest during routine work period. Our study revealed that surgeons with greater than 5 years of experience had a lesser increase in their postsurgery IL-6 levels in comparison to junior surgeons. Regarding BAI scores, in the health domain surgeons had a better and statistically significant adjustment in comparison to controls. In the overall total adjustment scores, controls, control subjects had significantly better scores. Conclusion : We found that the baseline IL-6 values were higher in surgeons in comparison to controls, in addition, our study demonstrated an increase in the IL-6 levels postsurgery. Therefore, we can conclude that IL-6 can be an effective marker of acute stress for further research in larger studies.
Serum Procalcitonin and CRP Level as Severity Marker of Dengue Fever : An Observational Study in Medical College, Kolkata
(Indian Medical Association, 2025-01) Ghosh, SK; Saha, M; Pal, S; Maji, S; Mondal, SS; Ghosh, UC
Background : Among different markers of inflammation and sepsis, Procalcitonin (PCT) and C-reactive Protein (CRP) are being studied to investigate their accuracy for the diagnosis of bacterial infections. However, their role in viral diseases like Dengue is less explored. Aims and Objectives : To find relationship between serum Procalcitonin and CRP with severity of Dengue Fever. Materials and Methods : An Observational study conducted among 100 Dengue patients (IgM Positive) and were subjected to Tests for Serum Procalcitonin and CRP along with other routine blood tests, results were compared between three groups Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Results : We found that mean CRP in DF, DHF, DSS are respectively 16.52, 42.59 and 77.20 and mean Procalcitonin in DF, DHF, DSS are respectively 0.0519, 0.2574 and 0.7800. Conclusion : We found that Abnormal CRP was more significant with DHF and DSS patients and Procalcitonin is more elevated in DSS, though abnormal Procalcitonin in DHF also statistically significant.
The Practice and Faculties Perception of Challenges on Implementing AETCOM Session : A Mixed Method Study
(Indian Medical Association, 2025-01) Roy, Hironmoy; Rawekar, Alka; Ray, Kuntala
Background : CBME curriculum has been made implemented since 2019 entrant batch. Since then as an integral part of CBME curriculum, AETCOM training has also been commenced throughout India in all Medical Colleges, with the NMC published AETCOM booklet as the guiding module for AETCOM training. But, so far the literature has been searched, faculties feedback on AETCOM teaching and assessment, not much explored. Aims and Objectives : (1) To explore the teaching learning methods as practiced, for AETCOM modules, (2) To explore the assessment methods, as practiced, for AETCOM, (3) To determine the perception of faculties, for challenges in implementing the AETCOM modules in their phase. Materials and Methods : The faculties of Phase 1 & Phase 2 disciplines have been chosen as they have conducted AETCOM classes and assessments for at least two times besides the COVID period. After the proper administrative approval, the Head of the Department(s) and the faculties of the Phase 1 & Phase 2 disciplines have been interviewed with a prestructured questionnaire having both close ended and open ended questions. The responses of the open ended questions was recorded during interview and later on analysed thematically. Result : All the faculties, who have been interviewed, were sensitized in faculty development programme (RBCW/ BCME). While revealing the department wise practice of AETCOM teaching, it was evident that, majority of the departments has taken the responsibility of teaching AETCOM modules except one. Commonly for each modules two hours get spend to teach. Only two departments (29%) used to take the small group sessions to teach AETCOM, whereas other uses lecture sessions for teaching AETCOM. None of the department has ever attempted for any integration for teaching AETCOM. Besides the NMC mandated 5 marks theory question only 37% have practice of evaluation of reflective writing. 75% departments also assess AETCOM in practical examination either in form of separate OSCE station (42%), or, as a part of the psychomotor station in OSCE carrying AETCOM items in checklist (42%). One department (12.5%) use to assess the AETCOM of the student by global assessment in oral-viva table. Whatever checklist they use in AETCOM assessment, are usually set in and validated in departmental meeting only. In COVID times AETCOM has been assessed theory exam, online viva as well as incorporating OSCE in summative examination. Faculties perceived ‘lack of willingness by all departmental faculties’ ‘low attendance of students’, ‘lack of validated SLOs’, the ‘difficulty in validation of checklists’, ‘less time for planning of OSCE stations’ perceived as the challenges for AETCOM assessment. Conclusion : Till today, when almost four years have passed since the commencement of AETCOM sessions, neither the teaching of AETCOM module nor the assessment of AETCOM is getting its proper way as was suggested in the module booklet; where the cause may be multifactorial. This study likes to explore the causes within its limitation.
The Success of Combined Trabeculotomy and Trabeculectomy in Patients with Primary Congenital Glaucoma Presenting to a Tertiary Care Centre
(Indian Medical Association, 2025-05) Bhadra, TR; Ghosh, RP; Samaddar, S; Ghosh, AK; Bhadra, T
Background : To find out the surgical success of combined Trabeculotomy with Trabeculectomy in patients with Primary Congenital Glaucoma in the population of Eastern India. Materials and Methods : It is an institution based, prospective, interventional study where 30 consecutive eyes from 25 patients were taken over a period of 18 months at a Tertiary Care Hospital of Eastern India. Diagnosis was made clinically and EUA was planned. Intra-ocular pressure, corneal diameter, axial length were measured and disc evaluation was done. Combined Trabeculotomy and Trabeculectomy was performed. The same four parameters were measured at the end of 1 month, 6months, 12 months and 18 months post operatively. Results : A significant reduction of IOP from 28.87±4.47 mm Hg to 12.33±1, 15.68±3.95, 17.95±3.21 and mm Hg at 1 month, 6 months, 12 months and 18 months respectively was seen (p<0.0001). 60% of all eyes showed complete success while 20% had qualified success. Patients presenting late had poorer prognosis. Axial length and cup disc ratio show significant reductions (p<0.05). Conclusion : Primary combined Trabeculotomy-Trabeculectomy is safe, effective, and sufficiently predictable to be considered the first choice of surgical treatment in Primary Congenital Glaucoma
An Imported Case of Multi-variant Complicated Severe Malaria — A Rare Case Report
(Indian Medical Association, 2025-05) Gandru, HK; Kamaraju, K
Background : Malaria is caused by the Parasite Plasmodium and is transmitted by mosquitoes called Anopheles. A case of malaria has been reported in a 37 year old male patient who has been in a Malaria-endemic country and returned to India. India is a country where Indian nationals often travel to foreign countries for business and other purposes. An elderly male, 34, reported a fever for 15 days, vomiting four episodes, headache for 14 days and intermittent loss of consciousness for two episodes. When the patient came to casualty and hospital course, the patient developed other manifestations of Severe Malaria. Our case report describes a case of Multi-variate Severe Malaria successfully treated with intravenous antimalarial drugs and oral primaquine in our hospital.
Custody Deaths Autopsied in Northeast Delhi Region : A 5-Years Retrospective Analysis
(Indian Medical Association, 2025-05) Meena, MC; Sellamuthu, H; Verma, SK; Bansal, MK
Background : On hearing custodial death, thought comes to the mind in most of us, is injustice and abuse of power and refers to the demise of an individual occurring while an individual is under the custody. It’s the duty of state is to provide healthcare to their citizen including those in custody. Materials and Methods : To find the trend, a retrospective autopsy-based study on death in custody was conducted in Northeast Delhi region for duration of five years (2019 to 2023). Results : A total of 9653 medico legal autopsies were conducted during the study period, in which 3.6%(n=83) involves custodial death. Male predominance 93.9%(n=78) was seen over female 6.1%(n=5). Majority of custodial deaths belonged to the age group of 21 to 30 years. Natural causes like septic shock, disseminated tuberculosis, cardiovascular diseases etc accounts majority 72%(n=65) cases. Among unnatural cause 21.6%(n=18), from suicide10.8%(n=9), due to violence 7.2%(n=5), due to accident 4.8%(n=4) was observed. Conclusion : Mandatory medical investigation and screening while during a person into custody and periodical health checkup with proper and timely medical care will prolong the lifespan and overall health status among the person in custody. As we are part of society, we need to work towards creating more humane and equitable systems of justice and healthcare that uphold the fundamental rights and dignity of all individuals, both inside and outside of prison walls.
Feto-maternal Outcome in Fetal Macrosomia : A Case-Control Study
(Indian Medical Association, 2025-05) Barua, M; Dasgupta, S; Basu, B; Biswas, J; Bhattacharya, N; Mahata, J; Maity, R
Background : Macrosomia may adversely affect feto-maternal outcomes and needs its risk factors to be evaluated during pre-conceptional and antenatal work up. Materials and Methods : An analytical case control study was conducted for one and half years in a Tertiary Referral Centre of India with mothers (n=47) giving birth to macrosomic babies weighing 4000 gm or above and they were compared with controls (n=47) with babies weighing between 2500-3999 gm in relation to the risk factors and pregnancy outcomes. Aim of the study was to determine the risk factors increasing the chance of macrosomia to happen and to compare the incidence of adverse feto-maternal outcomes in macrosomia with babies born with normal birth weight. Results : Maternal pre-pregnancy BMI and weight gain during pregnancy appeared to be strong risk factors (p<0.001) independently for macrosomia. Incidence of diabetes in pregnancy and morbidity related to Caesarean Sections (CS) were also high among cases (p=0.007 in both). Regarding neonatal complications higher incidence of neonatal hypoglycemia was reportedly found (p=0.010). Conclusion : Due to significantly adverse feto-maternal outcomes due to macrosomia, Obstetricians should keep vigilant regarding the risk factors prior to delivery to promote healthy pregnancy outcomes.
Comparison of Delays and Its Impact among Women who Delivered Normally versus Those Women who Needed Admission to the Obstetrics ICU of a Tertiary Care Hospital in Gujarat, India : A Case Control Study
(Indian Medical Association, 2025-05) M, V; P, SV; S, M; C, LT; R, R; C, SJ; P, JH
Background : Outcome of pregnancy may not always favorable for both mother and baby. Early recognition and effective response related to these complications is a boon to contend the unpredictable results of pregnancy. So, the present study was conducted to assess the delays in birth preparedness and its impact on delivery outcomes. Materials and Methods : A hospital-based case control study was conducted in a Tertiary Care Hospital. Participants were selected from postpartum delivery ward and obstetric ICU of the hospital. For cases 179 women were selected who required to get admitted in obstetric ICU during pregnancy and delivered whereas 179 women who had normal childbirth in hospital were selected for control group. Then both the group were interviewed and compared the delay present among them and its impact on delivery outcome. Result : Around 131(73%) cases and 120(67%) controls were found to have delays present at any level. Delivery outcomes shows 15(11%) intrauterine fetal deaths among cases and only 2(1%) in control group. Conclusion : Adverse maternal outcomes were seen in delays during pregnancy suggesting that timely and proper management are more helpful to mitigate them. More attention is required on the aspect of birth preparedness and complication readiness to reduce maternal mortality and morbidity.
Association Between Admission Hyperglycemia and Outcome in Acute Stroke Patients
(Indian Medical Association, 2025-05) Johnson, Linda P; Manigandan, A C Vaiera; Shanmugasundaram, Rajamani; G, Anoosh
Background : Patients with acute ischemic stroke have been found to have a higher risk of hemorrhagic transformation of infarcts and post-thrombolytic hemorrhage if their blood glucose level is high. Aims and Objectives : The aim of the study was to assess the relationship between admission blood sugar levels and the clinical outcome of patients admitted to the hospital within 24 hours of the onset of stroke. Materials and Methods : Among 50 patients admitted to a Tertiary Care Centre in Salem, Tamil Nadu, within the first 24 hours after suffering a stroke, a cross-sectional analytical study was conducted between January, 2020 and December, 2021. The study included all patients over 35 years of age, of both genders, who presented to the hospital with a stroke and fulfilled the eligibility requirements. The National Institutes of Health Stroke Scale is used to test the extent of stroke in each individual patient. Results : About a third of the patients were between the ages of 51 and 60. Nearly 64% of the patients were male. Most (64%) patients had co-morbidity hypertension, followed by a history of Diabetes Mellitus (42%). The severity of stroke among patients who presented with raised blood sugar was significantly higher when compared with patients who presented with euglycemia. Patients who presented with hyperglycemia had a 46.5% higher mortality rate than those who were euglycemic (4.5%). The mortality among patients who presented with hemorrhagic stroke was higher (33.3%) than that of among those with ischemic stroke (26.3%), though no statistical significance was seen. Conclusion : In this study, it was discovered that stroke patients had high rates of hyperglycemia at the time of presentation, which was associated with increased stroke severity and mortality. As a result, hyperglycemia in people with an acute stroke should be taken into account as a sign of a poor prognosis.
Assessment of Effect of Nicotine on Severity of Diabetic Retinopathy
(Indian Medical Association, 2025-01) Rathi, R; Jain, A; Maheshwari, R; Verma, S; Agarwal, D; Nema, N
Background : Diabetic Retinopathy (DR) is a microvascular complication of Diabetes, caused by high blood sugar levels that damages the vascular endothelial pericytes. DR is one of the most frequent causes of new cases of blindness among adults. Nicotine is a known risk factor for development of Diabetes and progression of DR. The aim of this study is to find the association of Nicotine with severity of DR. Materials and Methods : 100 type 2 diabetic patients, between 20 and 75 years of age, visiting the Department of Ophthalmology from July, 2021 to December, 2022, were divided into two Groups : Group 1 included Diabetics consuming nicotine (>2 years) and Group 2 had Diabetics without Nicotine addiction. Best corrected visual acuity was recorded followed by dilated fundus examination to look for DR. Visual acuity and severity of DR were compared in two groups. Results : The mean LogMar visual acuity in Group 1 was 1.13 and 0.84 in Group 2 (p<0.05). DR changes were found to be more severe in Group 1 as compared to Group 2 (p= 0.031). Proliferative DR was more common in nicotine users as compared to non-users (p=0.028). Increased duration of nicotine use resulted more severe DR (p= 0.0289). Conclusion : Nicotine has a deleterious effect on visual acuity and it causes more severe DR. It is recommended that physicians must counsel diabetic patients regarding abstinence from Nicotine besides doing routine Diabetes counselling.
Psychological Effect of Workplace Violence among Nurses in a Tertiary Care Teaching Hospital of Northern India — A Cross-Sectional Study
(Indian Medical Association, 2025-05) Aparnavi, P; Sharma, P; Roy, N; Verma, A; Khongsit, A; Dhivya, R
Background : Workplace violence is a significant social problem and is higher in the service sector including health care delivery. Materials and Methods : The current cross-sectional study on 290 nurses of both genders was done in 2020 at a teaching hospital, in Delhi, India. The emotional disturbances in four main domains were assessed on a five-point Likert scale for each type of violence separately if an individual had undergone more than one type of violence. Results : The affect scores were significantly lower for male victims of physical violence than for females. One person had faced sexual violence and his total affect score was 84% of the total score. A higher mean affect score was seen among victims of bullying. Conclusion : Workplace Violence in the healthcare sector also causes psychological effects among nurses. Hence, institutional level policies are required in place to prevent and manage WPV and its emotional effects.
Morphometric Study of Dorsal and Lumbar Pedicles in the Indian Population — A Retrosepctive Study of 150 Cases
(Indian Medical Association, 2025-05) D, MM; S, K; K, A; J, R
Background : The use of various sizes, types of pedicle screws in thoracic and lumbar spine is guided by the morphometry of the pedicles. Aims and Objectives : To study the dimensions and orientation of pedicles in the thoracic and lumbar spine in Konkan region in India. Materials and Methods : Pedicle dimensions of thoracic and lumbar spine of 150 people visiting a tertiary care hospital in Goa were studied. Results : The transverse diameter of pedicles from D5 to L5 varied from 4.51 to 10.1 mm, sagittal diameter ranged from 5.4 to 11.69 mm. Transverse angle ranged from 3.27 to 21.09, sagittal angle varied between 2.19 to 16.51. Conclusion : This study provides database of morphometric characteristics of thoracic and lumbar pedicles from D5 to L5 in population along Konkan coast of India and can provide information for future comparative studies.
Atropine-induced Psychosis in Organophosphate (OP) Poisoning Treatment : A Case Report
(Indian Medical Association, 2025-04) R, RV; P, S; H, Y; S, PS; R, D; N, MH
Background : Atropine is a naturally occurring alkaloid belonging to the Solanaceae family. Atropine blocks acetylcholine’s muscarinic-like effects on the central and peripheral nervous systems. The most common side effects of atropine are xerostomia, photophobia, impaired vision, and tachycardia, typically manifesting at or below the therapeutic dose. In this case study, a 45-year-old male patient received atropine for Organophosphate (OP) poisoning and experienced psychosis symptoms like agitation, visual and auditory hallucinations and anxiety
Unveiling Usage Patterns : Nikshay Poshan Yojana Scheme among Tuberculosis Patients at Vijayapura District Hospital — A Cross- Sectional Study
(Indian Medical Association, 2025-04) T, Kavimalar; Gudadinni, M R; Yadavannavar, M C
Background : Tuberculosis (TB) remains a global health concern with significant morbidity and mortality impacting populations worldwide. Tuberculosis and nutrition are intricately linked, To address this, GOI has initiated a program known as “Nikshay Poshan Yojana” to enhance the nutritional practice of tuberculosis patients, April, 2018, to offer a monthly financial incentive of INR 500 to all TB patients throughout the course of their treatment. This study seeks to evaluate the number of patients who have received benefits from the scheme and also to assess the utilization of the incentive. Materials and Methods : A descriptive study was conducted from October 2023 to January 2024, involving 320 Tuberculosis patients registered in the Nikshay portal between July and September 2023. Following institutional ethical clearance, data collection was carried out using the interview method during home visits. by a semi-structured questionnaire. Data was analyzed using SPSSV26. Results : Of 266 Participants, most were male (68.7%), primarily aged 26-40 years (45.8%). Among participants, 20% received full financial incentives, and 28% received partial incentives, with diverse utilization patterns observed. Reasons for not receiving incentives included lack of awareness (16%), no bank account (50%), and perceived lack of necessity (34%). Conclusion : The study reveals challenges in participant dynamics and incentive distribution, emphasizing the need for proactive outreach and tailored strategies to address barriers effectively
Vitamin D3 Insufficiency and Its Correlation with Disease Severity and Diagnostic Biomarkers in Rheumatoid Arthritis : A Case-Control Study
(Indian Medical Association, 2025-04) Sharma, M; Anand, KV; Kumar, A; Ram, VS; Sharma, P; Jawad, K
Background : This study aimed to identify Vitamin D3 insufficiency in patients with Rheumatoid Arthritis (RA) and investigate the correlation between Vitamin D3 and anti-cyclic Citrullinated Peptide (anti-CCP) antibodies and disease severity. The diagnostic value of Anti-CCP, RF, ESR, and hs-CRP was also evaluated. Methods: Selectra (Pro-XL) was used to estimate the lipid profile using commercially available kits. Anti-CCP and 25- (OH) Vitamin D (Vitamin D3) levels were measured using an immunoassay (ARCHITECT System, Abbott, Japan). The ESR was estimated using the Wintrobe’s tube method. RA factor and hs-CRP levels were measured using the immunoturbidity method. Disease activity/severity was estimated using the Clinical Disease Activity Index (CDAI) scoring. Results : The RA factor, hs-CRP and anti-CCP levels were significantly higher in patients than controls (p<0.0001), while Vitamin D3 levels were significantly lower (p<0.0001). A significant correlation was found between the RA factor and anti-CCP (r=0.678, p<0.0001), ESR and anti-CCP (r=0.469, p<0.0001) and a negative correlation between Vitamin D3 and anti-CCP (r=-0.224, p=0.046). Vitamin D3 levels were significantly correlated with the RA factor (r=-0.481, p=0.028). In patients with severe disease, Vitamin D3 level was associated with anti-CCP (?=0.409, p=0.018). The RA factor and anti-CCP demonstrated high specificity and sensitivity, with a PPV of 66% and 68% and NPV of 99.9% each. The AUC was significantly higher for anti-CCP (0.879, p<0.0001) and RA factor (0.813, p<0.0001) than for hs-CRP and ESR, indicating superior diagnostic performance. Conclusion : The study concludes that Vitamin D3 levels may determine the severity of RA and also suggests that the endorsed criteria should include the RA factor due to its diagnostic value equivalent to that of anti-CCP.
Impact of Revised Basic Course Workshop on Medical Educators : An Expedition of NMC Mandate to Formal Praxis !!!
(Indian Medical Association, 2025-01) Begum, Jarina; Ali, Syed Irfan; Lalitha, D Lakshmi
Background : Kirkpatrick’s model is one of the suitable methods for assessing educational programs at different levels. The present study is planned to evaluate the impact of the Revised Basic Course Workshop (rBCW) on medical educators. Aims and Objectives : (1) To evaluate the effects of rBCW on response, knowledge, and self-perceived behavior of faculties as per Kirkpatrick’s program evaluation model. (2) To identify the perceived challenges and suggest solutions to bridge the gap. Materials and Methods : An educational intervention was carried out among 28 faculties through the Faculty Development Program followed by a structured follow-up questionnaire. The data was analyzed in terms of percentage, proportions, paired t-test and thematic analysis. Result : The majority (71.4%) were male with a mean age of 36.21 years. All faculties were satisfied, 86.4% either agreed or strongly agreed with quality. Thematic analysis of reflections by participants highlighted a few important aspects of medical education system in terms of themes & subthemes. The increase in knowledge was evaluated by pre and post-test, which was found to be statistically significant (P<0.05). The behavior change was perceived positively by the participants. A few challenges were encountered like pandemic effects, lack of motivation & co-ordination, mismatched resources for which the suggested solutions were refresher training, more aligned resources, etc. Conclusion : All the faculties were satisfied with an increased knowledge & positive change in behavior after rBCW. Yet, it was perceived as inadequate in terms of various challenges during implementation which necessitated the need for the implementation of suggested solutions.
Prioritizing Physician Well-being : A Survey of Modern Medicine Doctors
(Indian Medical Association, 2025-04) S, AC; Jha, H; H, V
Background : The health and well being of doctors are paramount not only for their own sake but also for the welfare of their patients and the effectiveness of healthcare system. Lifestyle-related diseases are increasing Globally, affecting Clinicians as well. This study identified their health risks, stressing self-care and timely interventions. Materials and Methods : A cross-sectional online survey was conducted including 494 Clinicians, gathering data on demographics, work habits, lifestyle choices, and health metrics like BMI, neck and waist circumferences and Blood Pressure. We also assessed their daily activities, sleep duration and symptoms indicating potential health concerns. Results : The survey demographics showed a distribution of ages from 30-60 years with a male predominance (67.2%). Educational backgrounds varied, with Postgraduate degrees being prevalent (50.6% medical, 36.6% surgical). Work patterns indicated varied hours, with 31.4% working 6 to 8 hours daily. Physical activity was moderate, with 70.9% exercising daily. Sleep patterns were adequate (72.9% slept 6 to 8 hours), and dietary habits leaned towards Vegetarian choices (41.1%), with a high rate of eating out (81.6%). Common health issues included Hypertension (47.5%) and knee pain (86%). Lifestyle factors showed low smoking rates (92.3% never smoked) and occasional Alcohol consumption (71.7%). Increased BMI was associated with longer sitting and acanthosis nigricans was found to be associated with higher BMI. Conclusion : The survey found concerning health trends among Clinicians: longer sitting hours linked to higher BMI, especially in those with Acanthosis Nigricans. A significant number led sedentary lifestyles, lacked sufficient sleep and showed symptoms of obstructive sleep apnea.

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