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   Table of Contents - Current issue
July-December 2022
Volume 8 | Issue 2
Page Nos. 75-149

Online since Friday, September 2, 2022

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NABH: Should clinicians contemplate over quality of clinical care? p. 75
Sangeeta Pankaj
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Patient Safety vis-à-vis Safe Surgery: The Current Perspective p. 77
R Harsvardhan, Swati Choudhari
Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the leading causes of death and disability worldwide. Most of this patient harm is avoidable. As countries strive to achieve universal health coverage and the Sustainable Development Goals, the beneficial effects of improved access to health services can be undermined by unsafe care. The benefits of having a strategic and coordinated approach to patient safety, addressing the common causes of harm, and the approaches to preventing it have been recognized by policymakers and political and health leaders worldwide. Patient safety is defined as “A framework of organized activities that creates cultures, processes, procedures, behaviors, technologies, and environments in health care that consistently and sustainably lower risks, reduce the occurrence of avoidable harm, make errors less likely, and reduce the impact of harm when it does occur.” Surgical care has been an essential component of health care worldwide for a long. As the incidences of traumatic injuries, cancers, and cardiovascular disease continue to rise, the impact of surgical intervention on public health systems will only continue to swell. Surgery is often one of the significant therapies that can alleviate disabilities and reduce the risk of death from common conditions. Every year, millions of people undergo surgical treatment, and surgical interventions account for an estimated 13% of the world's total disability-adjusted life years (DALYs). While surgical procedures are intended to save lives, unsafe surgical care can result in substantial harm.
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Synthesis of 18fluoride-fluorodeoxyglucose and its clinical applications in positron emission tomography/computed tomography p. 82
Rajeev Kumar, Madhavi Tripathi, Aditi Khurana, Arunav Kumar, Shubha G Ravindra, Sumit Garg, Manish Kumar, Sanjay Kumar Suman
This review article covers a brief explanation on synthesis of Flourodeoxyglucose (18F–FDG) and its clinical uses with emphasis on practical uses. In present scenario, 18F–FDG is the most successful PET radiopharmaceutical because of its half-life and mode of uptake. 18F–FDG synthesised by electrophilic fluorination and Nucleophilic fluorination reaction (preferable Nucleophilic fluorination reaction). The simplicity in synthesis and clinical utility of 18F–FDG, together with its approval by the US FDA and the availability of PET radiopharmaceuticals are probably the main reasons for the flourish of clinical PET. Positron Emission Tomography (PET) has increased the accuracy of metabolic mapping of numerous malignancies, with significant impact on the management of cancer patients for initial staging, restaging and therapy monitoring. PET can provide functional information in addition to morphology from conventional imaging modalities. 18F–FDG is the most commonly used PET tracer and FDG PET can demonstrate the activity of glucose metabolism throughout the entire body in a single session. We describe the clinical utility of FDG in PET and display images of normal distribution and of patients.
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The onset of mucormycosis amidst COVID-19 crises in India: A systematic analysis p. 94
Shakti Rath
A descriptive analysis of the “Mucormycosis” or “black fungus infection” surge in India is given in this article. Amidst the pool of deadly COVID-19 crises and when India is suffering its second wave, another dangerous but rare fungal infection of mucormycosis is rising. This study analyses the occurrence and prevalence of black fungus infection between India and other countries with a higher or similar COVID-19 infection peak. This study also identifies that mucormycosis is a more significant problem in India than in any other country.
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Legal aspect of medical practice: A sojourn p. 98
Rajesh Harsvardhan, Rishabh Kumar, Ayush Mehrotra
The Consumer Protection Act (CPA), 1986 evolving over the strands of time by legal and judicial proceedings has given the consumers of healthcare services a legal recourse to air their grievances. Although it is important to punish guilty medical professionals, it is also equally important to protect medical professionals who act in good faith from harassment. Hence, courts need to strike a perfect balancing act.
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A novel black bone magnetic resonance imaging − An alternative to ionizing radiation in oral and maxillofacial imaging p. 105
Prarthana Govil, Abhishek Tayal
Over the decades, potential harmful effects of ionizing radiation continue to be a serious discussion among the researchers. Especially in the field of oral and maxillofacial imaging, the technique to reduce radiation doze to the humans has witnessed substantial advancement. The development of “BLACK BONE magnetic resonance imaging (MRI)” signifies dawn of new era in the head-and-neck imaging of the cortical bone, where this can be used as a replacement for computed tomography which is one of ionizing imaging modality used globally. Black bone MRI is a low flip angle MRI sequence which provides a high image contrast between bone and other tissues but reduces the contrast between the individual soft tissues thus enhancing bone soft-tissue boundary. This MRI sequence will eradicate radiation burden to the patient mainly pediatrics diagnosis and adult screening of benign and malignant lesions affecting the craniofacial region. This article explores this breadth of scientific discovery and its development.
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Craniofacial syndromes: Literature review and a proposed classification p. 109
Jaspreet Kaur Deo
Syndromes can potentially affect every part of the craniofacial system. While they have been described individually in the literature, there is lack of a classification system encompassing the entities affecting the craniofacial region. The purpose of this review was to provide clinicians an approach to categorize syndromes according to the morphostructural characteristics, which can aid in diagnostic ease and treatment planning.
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Immobilization devices used to treat unusual sites for better radiation delivery: A single institutional experience p. 117
Santosh Kumar, Rajeev Kumar, Satya Kumar, Bodhisatta Roy, Rajesh Kumar Singh, Alok Kumar
The present article illustrates an attempt to design and test the reproducibility of low-cost patient positioning devices prepared in-house in the radiotherapy department. A rigid wood-polymer composite material stands with angulations, scales, and support was designed as a new method for immobilization of the mobile target using a thermoplastic mask and a carbon fiber base plate. The lower mobile target, i.e., the penis of a patient, was immobilized by this method. A computed tomography simulation was performed for the patient. This device fit was suitable, comfortable, and had good reproducibility and repeatability, which was proven in daily radiotherapy. Reproducibility and accuracy were tested by serial electronic portal imaging detectors. The positioning devices showed variations within 2–3 mm on consecutive treatment days which were within acceptable limits. It is therefore concluded that low-cost patient positioning devices for the mobile target can be fabricated from available materials in-house. With the help of these in-house available materials, we can also fabricate other types of immobilization devices for particular techniques. It is considerably cheaper than commercially available products.
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Ophthalmological practices in COVID pandemic during first and second wave: Learnings and new beginnings p. 121
Vivek Singh, Abhishek Anand, Vidya Bhushan Kumar, Shadma Eqbal, Pragati Raj
Purpose: TO study the impact of covid 19 in a tertiary eye care hospital. Study type: single centre retrospective observational study. Method: Novel corona virus “COVID-19” is now an established global Pandemic. Index case of Novel Corona virus “COVID-19” virus was first reported from Wuhan, People's Republic of China on 31 December 2019. Bihar with a population of 120 million is one of the most densely populated and least developed states in India. With 1 doctor/29,000 persons and1 hospital bed/8,645 people, it was expected to be one of the worst hit state in COVID-19 pandemic. All patient visiting an ophthalmologist were seen with full precaution and with a practical Standard Operating Protocol (SOP), advised by World Health Organization (WHO), Centre for disease control (CDC), MOHFW, American Academy Of Ophthalmology(AAO) and All India Ophthalmological Society(AIOS). Patient visiting and treatment protocol followed in a tertiary care hospital were analysed. Results: 3617(2432 males ,1185 females) new patients and 3145(2149 males, 996 females) old/follow up patients visited RIO OPD from lockdown (25 march 2020) till unlock 4(30 September, 2020) which is about 85.41% decrement in comparison to last year in same period 21747(13335 males, 8412 females) new patients and 24610(15508 males, 9102 females). Conclusion: Proper use of n95 masks, gloves, caps, face shield, PPE kit while examining patients and operating them were few important precautions. Regular use of sanitizer, hand washing, minimizing patient doctor contact time, minimal hospital stays, use of artificial intelligence are few other ways practiced to prevent exposure to COVID 19. This pandemic has taught us a lot about people unity cooperation, what is important in life, ophthalmologically tele-ophthalmology will play a big role in future an evident in this pandemic.
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A study to rationalize the health-care (clinical and medical) record forms in use at SGPGIMS hospital, in conformance with inter/national guidelines, so as to ensure structural and contextual uniformity while updating the same for prospective in-house consumption by the end users p. 128
Rajesh Harsvardhan, Arushi Jaiswal, Prerna Kapoor, Rudrashish Halder
Background: Effectual management of medical records (MR) is a prime component in health-care delivery organizations. A standardized medical form facilitates for obtaining comprehensive information along with appropriate documentation for swift and efficient retrieval of information pertaining to the quality of patient care. It seems astounding that hitherto, there have been no set standards/criteria to evaluate MR forms. With this backdrop, the study aimed to rationalize MR forms in use at SGPGIMS in conformance with the inter/national guidelines as a stride toward quality improvement. Aim: The aim of this study was to rationalize the health-care (clinical and medical) record forms in use at SGPGIMS hospital, in conformance with inter/national guidelines, to ensure structural and contextual uniformity while updating the same for prospective in-house consumption by the end user. Objectives: The objective of this study was to obtain the health-care (clinical and medical) record forms in use at SGPGIMS hospital. To compare the health-care (clinical and medical) record forms in use at SGPGIMS hospital with inter/national guidelines through the appropriate designed tool, i.e., (structured checklist). To recommend an evidence-based modification in health-care (clinical and medical) record forms based on analysis of data obtained, to ensure structural and contextual uniformity while updating the same for the prospective in-house users, if required. Methodology: A descriptive study was carried out at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, with a study sample of preidentified health-care (clinical and medical) forms which are the core forms to all the departments of SGPGIMS, hospital. A customized validated tool kit (structured checklist) was designed in conformance with inter/national guidelines to assess the preidentified health-care (clinical and medical) forms. Results: The Medical Certificate of Cause of Death Form was found to have the highest compliance rate of 90.5% with the given set of parameters among the preidentified forms, while the Medication Chart and Assessment Form have noncompliance rates of 61.1% and 58.1%, respectively, with the given set of parameters. Rest other preidentified medical forms have the noncompliance rate of <50% with the given set of parameters of customized tool kit. Conclusion: Since this was the foremost study conducted, it was observed that there was a need to rationalize the MR forms by implementing the observations made, so as to ensure structural and contextual uniformity by the end users.
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Parental knowledge and awareness about measures taken by the dentist and attitude of parents toward bringing their children to dental hospital during the COVID-19 pandemic: A cross-sectional study p. 134
Umapathy Thimmegowda, K Soumya Pai, Navin Hadadi Krishnamurthy, Nagarathna Chikkanarasaiah
Background: In the early 2020, the world witnessed an enormous spread of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (2019-nCoV or SARS-CoV-2). It is common for parents to be frightened and their attitudes toward dental visits to change, given COVID-19's high contagion and fast spread. Aim: The aim of this study is to assess the parents' knowledge about coronavirus disease 2019 and measures taken by the dentist and to evaluate their attitudes/fears about bringing their children for dental visits during the pandemic. Materials and Methods: A structured questionnaire was developed in English and local language Kannada, which was applied to a sample of 400 parents of children aged between 4 and 12 years, of different socioeconomic backgrounds. Results: Regarding the knowledge about the COVID-19 pandemic among parents, 94% were aware about the present situation. 66% of parents perceived the dental hospital to be more dangerous when compared to public places. Regarding the attitude of parents in bringing their children to the dental clinic during the COVID-19 pandemic, 87.5% of the parents were comfortable in bringing their child to the hospital on following the COVID safety protocol. Conclusion: Majority of the parents remained well aware of the current situation about the pandemic. Patients were unlikely to take their children to the dentist except for an emergency and perceived the dental clinic as a risky place for contracting the virus. However, on providing reassuring information about infection control measures taken at the dental hospital, they were more comfortable in bringing their child to the dental hospital.
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Mucormycosis: A case report of black fungus as COVID-19 complication p. 141
Prarthana Govil, Priya Singh, Puja Rai, Abhishek Tayal
We report a case of post-COVID-19 mucormycosis infection caused by Rhizopus oryzae. The patient was diagnosed with COVID-19 and treated according to the existing protocols. Following recovery, the patient developed swelling and pain in the right upper region of the face. A diagnosis of mucormycosis was established after cone-beam computed tomography findings. The patient was referred to a government hospital where she was treated according to the COVID protocol. Generally, mucormycosis develops in patients who are immunocompromised or suffering from debilitating disease which was COVID infection and uncontrolled diabetes in this case. The mold usually gains entry through the respiratory tract involving the nose and sinuses, which can further progress to intracranial structures. Early diagnosis and intervention are the keys to good prognosis and decreasing morbidity. Judicious use of drugs is required in COVID-19 patients, especially in immunocompromised patients as research is still in progress. Opportunistic fungal coinfections are one of the complications which are needed to be taken care of. Prophylactic treatment protocols need to be established, along with rational use of corticosteroids.
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Diagnosis of external invasive cervical tooth resorption and its management using biodentine p. 146
Harakh Chand Baranwal, Jyoti Yadav, Prachi Rani, Silviya Samad, Aiyman Ayubi
Invasive cervical resorption (ICR) is a rare advancing and expansionist kind of external tooth resorption that commences within the cervical region. The treatment goal must be a complete elimination of all resorbing tissues and restoration of the resorptive defect with the placement of an acceptable filling material to achieve desired function and esthetics. The successful outcome of treatment depends on early detection and proper diagnosis. This article shows the detection and management of maxillary right central incisor in a 24-year-old female diagnosed with ICR, using biodentine and resin-modified glass ionomer cement.
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