Background: Every medical student in India have to undergo a compulsory rotatory internship for completion of their course where they encounter various medical emergencies and apply their medical knowledge. An early encounter to a basic life support course and training will increase the efficacy of cardiopulmonary resuscitation and thus the outcome of the patient. This study was designed to test knowledge of MBBS students in a tertiary care hospital.Methods: This observational study was conducted in a tertiary care hospital in Uttar Pradesh and used a preformed validated questionnaire to test awareness and knowledge of basic life support and cardiopulmonary resuscitation in a sample of 500 MBBS students. Descriptive analysis was performed on the questionnaire responses. All data obtained from the questionnaire was evaluated and statistically analysed using software IBM SPSS Statistics software version 24 (IBM Corp., Armonk, NY, USA) for MS windows.Results: With a response rate of 47% among 500 MBBS students, the mean score obtained was 2.34±1.066 out of a maximum score of five. A maximum score of 2.804±1.055 obtained by 5th-year students. Surprisingly, first-year students achieved an average score of 2.66±0.97, which was higher than that of 2nd, 3rd, and 4th year students. 87% of students were like-minded to participate in the cardiopulmonary resuscitation (CPR) awareness program. Only 45% of students correctly answered the order of CPR as C-A-B (chest compression-airway-breathing).Conclusions: The study showed that though the awareness and importance of basic life support (BLS) are high among the medical students, the accurate knowledge required in performing BLS is inadequate. This study also showed that the National medical commission has taken a positive step in the incorporation of BLS in the curriculum.
Sinonasal mucosal melanoma is a rare malignancy with limited treatment options and a poor prognosis. They are usually diagnosed at an advanced stage owing to their late and nonspecific clinical presentation. Here we present a case of relapsed refractory unresectable malignant melanoma involving the right nasal cavity managed with Oral Metronomic Chemotherapy (OMCT). A 75-year-old male patient was diagnosed with unresectable malignant melanoma involving the right nasal cavity and showed radiological progression after initial management with four cycles of Dacarbazine. He was then shifted to OMCT (Cyclophosphamide, Celecoxib and Tamoxifen), as immunotherapy could not be given due to financial constraints, on which he showed approximately 40% reduction in tumour size after 6 months. This result can have important clinical implications in resource constrained settings, where the use of immunotherapy is limited by great financial burden.
Background: With increasing numbers of people crossing the age threshold of 65 years, there is a strong likelihood that the cases of Alzheimer’s disease (AD) cases will increase manifold in the upcoming decades. It is essential for the healthcare professionals to have a reasonable background knowledge about this neurodegenerative condition. This study was done to assess the level of knowledge of AD among the healthcare staff appointed at a tertiary care hospital. Methodology: A cross-sectional survey study was done in a tertiary care hospital with healthcare workers. The knowledge level of AD was investigated using Alzheimer’s Disease Knowledge Scale (ADKS) while a self-assessment scale was used by the participants to rate their own knowledge about the disease. The extent of background knowledge was then statistically evaluated on the basis of multiple subject-oriented factors. The impact of any prior dementia-specific training was also assessed. Data were analyzed by using SPSS-23 where P value < 0.05 was considered significant. Results: Out of a total of 124 participants recruited during the study period, the average score on the ADKS scale was 19.2 ± 3.1. Self-rated Alzheimer’s scale depicted a mean value of 4.89 ± 1.7. The participants having a positive family history and personal/professional caring experience for AD did not obtain any remarkably better score. The doctors were more likely to score better than nurses and other healthcare staff (p < 0.001). Moreover, dementia-related training had a significantly better outcome in terms of promoting the knowledge base of AD (p < 0.001). Conclusion: There is a below-par knowledge of Alzheimer’s dementia among the healthcare staff of the hospital. The staff of the hospital realizes this shortcoming, and there is a need for dementia-specific training to overcome this knowledge gap.
Background: Lung cancer is the leading cause of cancer related morbidity and mortality accounting for 15.4 % of total cancer in Nepal. With revision of the Lung cancer staging system by International Association for the Study of Lung Cancerand adoption of seventh edition of staging system by American Joint Committee on Cancer in 2010, the application of seventh edition of staging system has significant impact on stage of disease which ultimately defines treatment strategyand overall prognosis.Objective: To improve stage precision by adapting new staging system, this will directly refl ect on disease treatment, survival and prognosis.Methodology: Medical records of 151 patients with lung cancer attending Oncology Department, between 2015 and 2016 were retrospectively reclassified using both sixth and seventh editions of staging system. Data were collected compared and managed using Statistical Package for Social Sciences. Ethical clearance was obtained from Institutional Review Board.Results: Stage migration was seen in 15.23 % of total cases. Seven percent of cases staged down from IIIB to IIIA. Four percent were staged up from IIIB to IV. Remaining were down staged from T4 to T3 and T3 to T2 due to sub categorization of tumor by size in seventh edition.Conclusions: There was downstage from IIIB to IIIA and upstage from IIIB to IV because of revised staging system. Thus, it is essential to have detailed radiological staging and routine pleural fluid cytology before initiation of treatment, which will further help to stage accurately and treat properly. This carries direct impact on prognosis and survival. Journal of Kathmandu Medical College,Vol. 7, No. 2, Issue 24, Apr.-Jun., 2018, Page: 55-58
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