Bengal Physician Journal

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2023 | September-December | Volume 10 | Issue 3

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EDITORIAL

Nandini Chatterjee

Competency-based Medical Education: A Fresh Perspective

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:2] [Pages No:77 - 78]

   DOI: 10.5005/jp-journals-10070-8026  |  Open Access |  How to cite  | 

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Original Article

Thoraa Abdul Amir Drees, Falah Hasan Obayes AL-Khikani, Haider Hussein Yas Khudair, Haider Abdul Hussein Nuri, Ali Amer Hussein

Possible Synergism between Ampicillin and Some Pain-reducing Drugs against Escherichia coli

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:4] [Pages No:79 - 82]

Keywords: Ampicillin, Escherichia coli, Dexamethasone, Diclofenac sodium, Flagyl, Paracetamol, Synergism

   DOI: 10.5005/jp-journals-10070-8020  |  Open Access |  How to cite  | 

Abstract

Background: Escherichia coli (E. coli) is one of the most common human bacterial pathogens implicated in antibiotic resistance, especially in the last decades. The antimicrobial combination is important to reduce these resistances. So the aim of this study is finding a possible synergism between ampicillin and other drugs to treat E. coli infections. Materials and methods: The present study was conducted for the period from January 2023 to March 2023 on bacteria E. coli. The tested bacteria isolated and identified by using standard bacteriological methods. Detection antibiotic sensitivity pattern of isolates was determined by agar well diffusion method. The antibiotics (flagyl, paracetamol, dexamethasone, diclofenac sodium, and ampicillin) were added separately in one dish, and then added in another dish combined with the ampicillin to know the effect of antibiotics on the growth of bacteria before and after the addition of ampicillin. Results: Twenty E. coli were isolated from various body sites. The study showed that females were more infected (70%) with E. coli than males (30%). Flagyl, paracetamol, and dexamethasone were resistant to all isolates (100%). But diclofenac sodium was resistant to 85% isolates. Resistance to ampicillin was 50%. Ampicillin showed synergy after combination with other agents but still nonsignificant (p > 0.05). The addition of flagyl increased the effect of ampicillin to 15.35 mm while it was 13.75 mm before the combination (p = 0.53). The addition of paracetamol increased the effect of ampicillin to 15 mm while it was 13.75 mm before the combination (p = 0.63). The addition of dexamethasone increased the effect of ampicillin to 15.55 mm, it was 13.75 mm before addition (p = 0.51). The combination of diclofenac increased the effect of ampicillin to 14.95 mm, it was 13.75 mm before addition (p = 0.64). Conclusion: Flagyl, paracetamol, and dexamethasone were resistant to all isolates (100%). But diclofenac sodium was resistant in 85% of all isolates. Ampicillin showed synergy after adding other agents but still non-significant (p > 0.05).

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Original Article

Rupak Chatterjee, Shatavisa Mukherjee

Knowledge, Awareness and Health-seeking Behavior Regarding Dengue among Residents of Urban Kolkata, West Bengal

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:5] [Pages No:83 - 87]

Keywords: Dengue, Health seeking behavior, Knowledge, Urban residents, West Bengal

   DOI: 10.5005/jp-journals-10070-8024  |  Open Access |  How to cite  | 

Abstract

Background: As dengue is a preventable vector-borne disease, the community's knowledge, attitude, and health-seeking behavior play an important role in successfully preventing the upsurge of cases and reducing mortality. This study thus tried to assess the knowledge, awareness, and health-seeking behavior among the Urban Kolkata residents. Methods: A cross-sectional observational study was performed among urban residents visiting the community healthcare center in Urban Kolkata. The survey questionnaire was formulated, tested, and administered to assess the knowledge, awareness, and health-seeking behavior regarding dengue. Responses were statistically analyzed. Results: The study was conducted on 158 residents of Urban Kolkata. 69.62% of individuals pointed out stagnant water as a prime mosquito breeding area and 77.22% of subjects held dark indoor places as the main resting place of dengue mosquitoes during the day. All respondents believed that cleaning mosquito breeding and resting places and using mosquito repellents were the most preventive measures. 83.54% of respondents believed cleaning the house surrounding to be an effective mode of breeding prevention. 51.90% of respondents would attend a government healthcare facility in the event of encountering fever, followed by 20.25% opting for private consultation and 18.99% self-treating themselves with over-the-counter drugs. Only 39.34% knew that bleeding was a warning sign. Knowledge parameters showed a significant positive association with age and educational status (p = 0.001). Conclusion: Dengue awareness is essential to prevent and control the spread of the disease, reduce its impact on public health, and foster a sense of responsibility within the community. Public health campaigns, educational programs, and community engagement are important tools in raising awareness about dengue and its prevention.

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REVIEW ARTICLE

Gyanendri Tomar, Aditi Chauhan

Unleashing the Potential: Artificial Intelligence's Transformative Impact on Healthcare and Nursing

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:3] [Pages No:88 - 90]

Keywords: Artificial intelligence, Collaboration, Healthcare professionals, Nursing practices, Remote monitoring

   DOI: 10.5005/jp-journals-10070-8021  |  Open Access |  How to cite  | 

Abstract

The convergence of artificial intelligence (AI) with the healthcare landscape signifies a pivotal juncture, poised to catalyze transformative shifts in both the medical and nursing spheres. Artificial intelligence's capacity to replicate human cognitive functions holds vast potential across medical diagnosis, treatment strategies, patient management, and nursing practice. Concurrently, integrating AI into nursing practice brings forth an array of opportunities, from clinical decision support systems to remote patient monitoring, fostering heightened patient care, and operational efficiency. Despite the attendant challenges and ethical considerations, the synergistic relationship between AI and healthcare professionals promises to redefine patient outcomes and reshape the essence of healthcare provision. With ongoing advancements in AI, medical professionals and nurses alike are positioned to leverage its potential, steering healthcare into an era characterized by tailored, effective, and compassionate medical services.

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REVIEW ARTICLE

Shambo S Samajdar, Ayona Chowdhury, Santanu Kumar Tripathi

Microteaching Mastery: Elevating Postgraduate Medical Training

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:5] [Pages No:91 - 95]

Keywords: Challenges in implementation, Medical education, Microteaching, Pedagogical tool, Postgraduate evaluation, Reflective teaching, Skill development, Teaching techniques

   DOI: 10.5005/jp-journals-10070-8025  |  Open Access |  How to cite  | 

Abstract

Microteaching, a pedagogical tool initially developed for teacher education, has found its firm foothold in medical education training programs. This narrative review highlights its pivotal role, merits, demerits, and practical implications, particularly in postgraduate evaluations. Emphasizing lesson planning, presentation skills, and effective use of audiovisual aids, microteaching facilitates a deeper understanding of the teaching process and its complexities. Various studies have demonstrated its positive impact on teacher knowledge growth, confidence-bilding, and skill retention, while also promoting problem-solving, critical thinking, and reflective teaching. Beyond the health sciences, it is proven effective in subjects like mathematics. However, challenges persist, with time constraints during sessions and potential administrative bottlenecks when managing large classes. Despite these limitations, the importance of preparing postgraduate candidates for microteaching evaluations is undeniable, requiring a comprehensive understanding and practice of the core skills. The review concludes by advocating for a more widespread adoption and adaptation of microteaching techniques, particularly in regions like India, where its potential remains under-tapped.

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CASE REPORT

Swamy Kondapally, Pramod Kumar Samala, Sakthi Velayudham, Malcolm Jeyaraj, Sowmini Perumal, Kannan Vellaichamy, Viveka Saravanan Raju, Mugundhan Krishnan

Chlorpyrifos-induced Delayed Myelopathy and Pure Motor Neuropathy: A Rare Case Report

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:3] [Pages No:96 - 98]

Keywords: Case report, Chlorpyrifos, Myelopathy, Organophosphates poisoning, Pure motor neuropathy

   DOI: 10.5005/jp-journals-10070-8003  |  Open Access |  How to cite  | 

Abstract

Organophosphate (OP) poisoning is known to cause delayed neurological manifestations. Chlorpyrifos, an OP, causes a delayed syndrome that is characterized by motor sensory polyneuropathy. Pure motor neuropathy with intact sensory conduction is rarely documented. Rapidly evolving delayed myelopathy is extremely uncommon. A healthy 46-year-old male, known alcoholic and smoker without any comorbidities was admitted to the hospital with a cholinergic crisis due to ingestion of chlorpyrifos (OP). He was on mechanical ventilation for 20 days and treated with atropine, pralidoxime, and other supportive measures. After his sensorium improved, he noticed a flail type of weakness in both lower limbs. He also noticed weakness, thinning, and clawing in both hands. No history of (h/o) muscle twitching, bowel and bladder disturbances, and sensory system involvement. After 1 week, patient noticed truncal weakness and also stiffness in both lower limbs. On examination (o/E) he had spasticity in all four limbs. All reflexes are brisk with absent ankle reflex and bilateral extensor plantar. Electrophysiological studies revealed pure motor neuropathy. A spine magnetic resonance imaging (MRI) showed atrophy of the entire spinal cord. Other causes of myelopathy and neuropathy were excluded. The pathology of OP-induced delayed neuropathy (OPIDN) involves a central-peripheral distal axonopathy. The axonopathy is thought to be attributed to the inhibition of neuropathy target esterase (NTE) by phosphorylation and subsequent aging of NTE, causes Wallerian-type degeneration of the axon, followed by myelin degeneration of long and large diameter tracts of the peripheral and central nervous systems. Peripheral distal axonopathy results in predominantly motor polyneuropathy. Axonopathy of the central nervous system results in myelopathic features. Pure motor neuropathy with intact sensory conduction is rarely documented. Rapidly evolving delayed myelopathy is extremely uncommon which makes for a poorer prognosis.

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CASE REPORT

Naga Srinivas PS, Malcolm Jeyaraj, Sakthi Velayudham, Sowmini Perumal, Kannan Vellaichamy, Viveka Saravanan Raju, Mugundhan Krishnan

A Case of Tuberous Sclerosis Presenting with Gelastic Seizures

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:3] [Pages No:99 - 101]

Keywords: Case report, Cortical tubers, Gelastic seizure, Tuberous sclerosis complex

   DOI: 10.5005/jp-journals-10070-8011  |  Open Access |  How to cite  | 

Abstract

Gelastic seizures (GS), an uncommon epileptic seizure type, have been described as the hallmark of seizures arising from the hypothalamus, with hypothalamic hamartoma (HH) being the frequent underlying pathology. These are mostly seen in children as intractable seizures with sudden outbursts of unprovoked stereotyped laughter as the main ictal manifestation, commonly in association with precocious puberty, behavioral disturbances, and cognitive impairment. Gelastic seizures are also seen with complex partial seizures of the frontal or temporal lobe as well as the cingulate gyrus with or without radiologically evident structural lesions. Herein, we present a child with tuberous sclerosis complex (TSC) who presented with GS not associated with HH.

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CASE REPORT

Pramod Kumar Samala, Sowmini Perumal, Sakthi Velayudham, Malcolm Jeyaraj, Kannan Vellaichamy, Viveka Saravanan Raju, Mugundhan Krishnan

Uveitis and Retinal Vasculitis—Harbingers of Neuro-Behcet's Disease: A Case Report

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:3] [Pages No:102 - 104]

Keywords: Case report, Neuro-Behcet's disease, Retinal vasculitis, Stroke-like episodes

   DOI: 10.5005/jp-journals-10070-8022  |  Open Access |  How to cite  | 

Abstract

We report this case of Neuro-Behcet's disease who initially had recurrent episodes of uveitis over a period of 14 years and was under ophthalmological follow-up. Recently, she developed retinal vasculitis and multiple stroke-like episodes. She was evaluated for Behcet's disease. Pathergy test and HLAB51 were positive. She had characteristic diencephalic lesions on neuroimaging and responded well to immunotherapy. Key message: Uveitis and retinal vasculitis may be harbingers of Neuro-Behcet's disease. Rare neurological manifestations such as stroke-like episodes can occur much later in the course of Behcet's disease with unique neuroimaging findings.

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CASE REPORT

Anandi Damodaran, Leena Awad Ahmed, Rehab Abdoqasem, Devdutt Nayak Kotekar

Ischemic Stroke Following Spontaneous Intracerebral Hemorrhage in a Patient with Protein S Deficiency: A Case Report

[Year:2023] [Month:September-December] [Volume:10] [Number:3] [Pages:2] [Pages No:105 - 106]

Keywords: Case report, Intracerebral hemorrhage, Ischemic stroke, Ischemic stroke following intracerebral hemorrhage, Protein S deficiency

   DOI: 10.5005/jp-journals-10070-8027  |  Open Access |  How to cite  | 

Abstract

Intracerebral hemorrhage (ICH) accounts for 20% of all strokes and is a significant cause of mortality and disability. Intracerebral hemorrhage survivors are at high risk of recurrence of ICH with a risk of 1.3–7.4%. While we are more concerned with the recurrence of ICH, ischemic infarcts are also frequent. This raises the therapeutic dilemma about the benefit of starting antithrombotic agents without increasing the risk of ICH. Here we report a patient who presented to our hospital with hypertensive parenchymal bleed and later developed cerebellar infarct within 1 week of admission. Our patient is a 40-year-old male without any comorbidities presented with accelerated hypertension and right hemiparesis. Computed tomography (CT) was done immediately showed intracerebral bleed with intraventricular bleed. Repeat CT brain one week later showed subacute infarct in cerebellar region. On further work he was found to have protein S deficiency. Intracerebral hemorrhage survivors have an increased risk of recurrent hemorrhage and ischemic stroke. Data on the burden of ischemic events and their predictors following an ICH is still lacking. Various studies observed that prior ischemic stroke, aggressive blood pressure lowering, and surgical evacuation of ICH were independently associated with diffusion-weighted lesions. It is also postulated that aggressive lowering of blood pressure in chronic hypertensive ICH patients can compromise cerebral perfusion pressure which contributes to ischemic injury. According to the limited studies so far, primary ICH patients are at risk of another major vascular event including ischemic stroke. This poses a therapeutic dilemma about blood pressure lowering and also the time frame to start antithrombotic. Further studies may be needed to determine and analyze the risk factors for developing ischemic injuries and the impact of these infarcts on the outcome and optimal management strategies to arrest vascular damage.

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