Global Journal of Medical Students
https://www.thegjms.org/journal/index.php/gjms
Global Association of Indian Medical StudentsenGlobal Journal of Medical Students2583-5408Stigmatization of Monkeypox to MSM can Overshadow the Other Risk Factors
https://www.thegjms.org/journal/index.php/gjms/article/view/53
<p>Soon after the pandemic, a new species of orthopoxvirus, that is the Monkeypox virus, is now a leading threat to the world, especially in the American, European and African regions where the highest number of cases are reported by WHO in 2022. Few studies ruled out the fact that MSM (Men who have sex with men) societies are at the highest risk to get infected by Monkeypox as seen in European and non-European regions where male-to-male sexual relations are common. Thus, sensationalizing the disease with just one group of people could overlook various other factors and traits that need attention for preventing Monkeypox</p>
CorrespondenceAlmas ZafarUshna Zameer
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2023-07-242023-07-24394010.52314/gjms.2022.v2i2.70The Effects of High BMI on Transmasculine Chest Wall Masculinization
https://www.thegjms.org/journal/index.php/gjms/article/view/52
<p>Gender dysphoria is a condition that has a significant impact on a person’s long-term physical and psychological health. It is characterized by clinically significant suffering or impairment as a result of gender incongruence, including a desire to change one’s primary and/or secondary sex characteristics<br>Gender-affirming surgery is critical for alleviating these symptoms of gender dysphoria and has been shown to improve quality of life.<br>Chest masculinization goals include cosmetic chest wall contouring, appropriate nipple reduction and location, and scar minimization on the chest wall. Obese patients are often rejected from this treatment due to worries that one of these four goals would be jeopardized. In contrast to having a high BMI, it was discovered that minimal incision operations, prior testosterone usage, and smoking history were all risk factors for problems that should be considered during preoperative planning. We also request that Plastic Surgery associations such as the Association of Plastic Surgeons of India and the American Society of Plastic Surgeons provide surgical guidelines.</p>
CommentaryHigh BMITransmasculinizationAssociation of Plastic Surgeons of IndiaAmerican Society of Plastic SurgeonsNirupam Nadella
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2023-07-242023-07-24373810.52314/gjms.2022.v2i2.75Are Medical Students the New Guinea Pigs? - A Perspective
https://www.thegjms.org/journal/index.php/gjms/article/view/51
<p>There has been an increasing trend of research studies bearing the phrase “medical students” in their title or keywords. In the haste of publication, the relevance of study population is being forgotten and an emerging phenomenon has been making its presence, that we would like to call the “guinea pig effect”- wherein the choice of study population invariably ends up being members of the medical fraternity- whether or not it is relevant to the research question at hand. To give a rough estimate, a search via Google Scholar with keywords (Medical Student India -Education -Teaching) yields 4,43,000 results while a PubMed search brings 145 indexed papers. Most of these studies are either one-time KAP studies or Mental Health surveys. During the COVID-19 pandemic such studies have been on the rise, which has reduced the scientific quality of evidence. Convenience, lack of resources, time constraints, and easy access to a vulnerable population are the key factors driving such studies. These studies have an inherent selection bias, poor generalizability, and ethical concerns like over-researching a vulnerable population. As a consequence, they contribute to survey fatigue among students leading to poor response rates and quality of collected data. To tackle this, we advocate for the use of appropriate population selection and participant recruitment strategies. To conclude, researchers need not shy away from recruiting medical students as the study population where required, but they must make it a point to re-evaluate the applicability and reach of their study topic in all the populations.</p>
PerspectiveMedical StudentsStudy PopulationSurvey FatigueOver-researchingShirish Rao Ishita Lanjewar
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2023-07-242023-07-24343610.52314/gjms.2022.v2i2.64Metastatic Gastric Carcinoma with Gastric Outlet Obstruction Extirpated by Palliative Gastrojejunostomy
https://www.thegjms.org/journal/index.php/gjms/article/view/50
<p>Gastric cancer, third most common cause of death due to cancer and the fifth most common cancer across the world, present with symptoms like early satiety, nausea, vomiting, abdominal pain and loss of weight. The common age of presentation lies between 50 to 70 years. Here, we discuss about a case of a 50years old patient presented with chief complaints of pain in the epigastric region, insidious in onset, gradually progressive, burning in nature and associated with early satiety and bloodstained vomiting. Upper Gastrointestinal Endoscopy (UGIE), Endoscopic biopsy and Contrast Enhanced Computed Tomography (CECT) were in favor of Metastatic Gastric Adenocarcinoma obstructing Gastric Outlet. Considering Gastric outlet obstruction, the patient underwent Palliative Gastrojejunostomy and Postoperative Radio chemotherapy. This case emphasizes the significance about considering palliative surgical care in improving the patient compliance and quality of life. </p>
Case ReportMalignant Gastric AdenocarcinomaPalliative GastrojejunostomyUpper Gastrointestinal EndoscopySai Kiran KuchanaMohan Nayak GugulothKshitija Reddy GDevang SrivastavaShubhangi OjhaNarasimharaju Ailapuram
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2023-07-242023-07-24303310.52314/gjms.2022.v2i2.46A Case of Takayasu Arteritis in a Male Patient
https://www.thegjms.org/journal/index.php/gjms/article/view/49
<p>Takayasu arteritis (TA), otherwise called “pulseless disease”, is a category of primary systemic vasculitis involving medium and large arteries, including the aorta, its branches and the pulmonary and the coronary arteries. The presence of TA is often observed in women and the main population of patients develops their first symptoms between 15 years to 30 years. If left untreated, this disease may lead to the development of many comorbid renal and pulmonary obstructions causing lethal consequences. <br>Here we present a case report of the diagnosis of TA in a 25-year-old male, treatment and following procedures. A patient with no anamnesis was hospitalized with paralysis of the right half of body and altered consciousness. He had been experiencing symptoms like fatigue, general weakness and respiratory distress for the past year. After extensive medical analysis patient was treated with oral prednisone and later endarterectomy was performed. After the operation, the patient improved and was discharged. Till date, no new complaints were reported. </p>
Case ReportTakayasu ArteritisPrimary Systemic VasculitisAneurysmRheumatologySuvam BanerjeeElina Semenenko
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2023-07-242023-07-24272910.52314/gjms.2022.v2i2.71Correlation Between Fetal Middle Cerebral Artery and Umbilical Artery Doppler Ratio at 38-40 weeks of Gestation with Fetal Distress and Adverse Perinatal Outcome
https://www.thegjms.org/journal/index.php/gjms/article/view/48
<p>Background and Objectives: The study aimed to determine the correlation between fetal middle cerebral artery and umbilical artery doppler ratio with fetal distress at 38-40weeks of gestation. <br>Materials and Methods: In this prospective observational study, 100 pregnant patients between 38-40 weeks of gestational age with no complications were selected from April 2020 to October 2021.They were subjected to Doppler ultrasonography and all the indices such as Middle cerebral artery, Umbilical artery, and Cerebroplacental (C/U) ratio were noted. The patients were followed till delivery and monitored for maternal, fetal, and neonatal outcomes. <br>Results: The mean cerebroplacental ratio was 1.33. there was a significant association between the low C/U ratio with caesarean section and poor perinatal outcome in terms of APGAR <7 at 5minutes, meconium liquor, respiratory distress syndrome, neonatal death, and NICU admission. There was a significant association of low middle cerebral artery PI (p=0.0004), high umbilical artery PI (P=<0.0001), and low C/U ratio (p=<0.0001) with fetal distress. The C/U ratio cut-off ≤1.33 led to sensitivity, specificity, PPV, and NPV of 82.86, 78.46, 67.4, and 89.5%, respectively. There was a linear relationship between birth weight (p=0.10) and postdelivery cord pH(<0.0001) with a C/U ratio. Hence, although sensitivity of cerebroplacental ratio and umbilical artery PI are comparable, the specificity of cerebroplacental ratio is higher than that of umbilical artery PI. <br>Conclusion: It may be concluded that the Cerebroplacental ratio is a better predictor of fetal distress and adverse perinatal outcome than the individual pulsatility index of middle cerebral artery and umbilical artery taken alone.</p>
Original ResearchCerebroplacental ratioColour dopplerPulsatility IndexUmbilical arteryMiddle cerebral arterySaloni PugaliaSabrina MhapankarShruthi ShettySushil Kumar
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2023-07-242023-07-24212610.52314/gjms.2022.v2i2.72Identification of Therapy Pattern and Compliance of Life Style Modifications in Diabetic Patients from Rural Areas of Puducherry
https://www.thegjms.org/journal/index.php/gjms/article/view/47
<p>Background: Diabetes mellitus is one of the leading causes of mortality and morbidity throughout the world. Despite India being the diabetes capital of the world with a high prevalence even in rural regions, pharmacotherapy of diabetes is not uniform throughout the country. With this background, we aimed to identify patterns in pharmacotherapy and willingness and preferred choices of lifestyle modifications in diabetic patients hailing from rural areas of Puducherry.<br>Methods: A facility-based cross-sectional survey was conducted with a validated questionnaire among 200 diabetic patients in rural areas of the union territory of Puducherry. Eligible patients fulfilling the inclusion criteria were enrolled in the study and were subjected to the validated questionnaire. Data were entered into M.S. Excel 2010. Categorical variables were expressed as frequencies and percentages.<br>Results: The current study shows that 78% (n=156) of the study population was overweight. Only 15% (n=30) of the patients observed symptoms of diabetes mellitus indicating poor glycemic control and more than 25% (n=50) of the patients had retinopathy within two years of diagnosis. Almost 17% (n=34) of the patients felt that they should attend the doctor’s clinic only for complications. Approximately 2% (n=4) of the population did not involve in any of the physical activities and 4% (n=8) of the population were not following any dietary changes to control their blood sugars. <br>Conclusion: A proper updated educational program is needed to update the knowledge of both the rural community and the primary healthcare physicians on recent advances in the holistic management of diabetes mellitus.</p>
Original ResearchDiabetes MellitusDiabetic ComplicationsHealthcare EducationLifestyle ModificationsTherapy PatternReka DevaPriyadharsini RajendranGaurang Narayan
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2023-07-242023-07-24152010.52314/gjms.2022.v2i2.68Single Cell RNA Analysis of Glioma Neural Stem Cells Shows Disturbed Amino Acids Metabolism and Axonal Growth Cone Dynamics in Glioblastoma Multiforme
https://www.thegjms.org/journal/index.php/gjms/article/view/46
<p>Glioblastoma multiforme(GBM) is a group of aggressive tumors of the central nervous system. Despite advancements in the treatment of GBM, patients diagnosed with these tumors typically have a poor prognosis and poor quality of life as the disease develops. The single-cell RNA high-throughput sequencing processed data for Glioma cancer stem cells were taken from GEO and analyzed to find out the underlying expression differences at the gene level between glioma neural stem cells(GSCs) and Normal neural stem cells(NSCs). In the current study, we have performed an RNA-sequencing analysis between GSCs and NSCs to better understand the origin of GBM. We have performed bioinformatics analysis on the transcriptional profile of 134 samples which consisted of 75 GSCs and 59 NSCs obtained from the NCBI bio project(PRJNA546254). First, an exploratory analysis was performed which showed significant variation patterns between GSCs and NSCs. Subsequently, Deseq2 differential gene expression analysis identified 1436 differentially expressed genes between GSCs and NSCs[(padj. value <0.05, log2 fold change (>=+/-1.5)]. This study reveals genes like MAOA, MAOB, GATM, GLDC, AMT, and SHMT1 as the key features contributing to the disturbed processes of Glycine, threonine, and serine amino acid metabolism, axonal cone growth curve, and cell migration in Glioma. Conclusively, our study also depicts gene expression changes in amyloid beta-binding protein in between GSCs and NSCs which plays an important role in tumor microenvironment formation. Besides, the results presented here reveal new insight into the progression of GBM and the identification of novel genes involved in gliomagenesis.</p>
Original ResearchGlioblastoma MultiformeNeural stem cellsExtracellular MatrixGliomagenesisRutvi Vaja
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2023-07-242023-07-2451410.52314/gjms.2022.v2i2.53Age-related Macular Degeneration: A Changing Paradigm in the 21st Century
https://www.thegjms.org/journal/index.php/gjms/article/view/45
<p>Age-related Macular Degeneration (AMD) is an acquired degenerative disease of the vital cells at the macula, the most critical area of the retina, that results in significant impairment of central vision due to non-neovascular and neovascular processes. It is the foremost cause of irreversible vision loss among individuals 60 years or older and constitutes 8.7% of all causes of blindness worldwide. The dawn of this century has seen a paradigm shift in insights into and management of this potentially blinding condition with a possibility of dramatically improved visual outcomes at least for some.</p>
EditorialAjeet Madhav Wagle
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2023-07-242023-07-241410.52314/gjms.2022.v2i2.77Plastic Surgery in India: Where Are We Now?
https://www.thegjms.org/journal/index.php/gjms/article/view/44
<p>Plastic surgery is a specialized subject that defies categorization, lacks a particular organ system, and is more concerned with concepts than procedures. The first detailed explanation of plastic surgical operations may be found in the ‘Sushruta Samhita,’ a clinical book on Indian surgery (circa 600 B.C.). After World War II, India began to practice modern plastic surgery. There was no such thing as plastic surgery as a recognized specialty in the nation. In 1958, the M.C.Hospital in Nagpur established the country’s first autonomous Department of Plastic Surgery. In 2018, 895,896 plastic surgery treatments were done in India, including 390,793 surgical procedures and 505,103 nonsurgical procedures, ranking India fifth in the world for the total number of plastic surgery procedures performed.</p>
CorrespondenceNirupam Nadella
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2023-07-242023-07-24373810.52314/gjms.2022.v2i1.34Establishing a Centralized Logistical Triage Platform to facilitate Supply Chain Optimization for Critical Resources during COVID-19 in a Developing Country
https://www.thegjms.org/journal/index.php/gjms/article/view/43
<p>Problem: The COVID-19 pandemic has resulted in significant resource deficiencies, especially with regards to basic facilities required for the safety of Healthcare Professionals (HCPs) such as Personal Protective Equipment (PPE). Resource deficiency can be attributed both to inadequate production and to misdirected distribution due to deficits in the global supply chain, particularly in a time-sensitive situation like this. Low-Middle Income Countries (LMICs) face the added burden of economic constraints and underdeveloped healthcare infrastructure. Lack of a centralized approach, ineffective rapid communication (especially amongst private and public entities), stockpiling and inefficient resource allocation further exacerbate this underlying issue.<br>Approach: Project Alloy has worked on building a platform for “Logistical Triage” to strengthen the coordination of resource networks in crisis situations. We aim to facilitate supply chain optimization by tackling inequitable resource distribution through a centralized management approach. Through our portal, healthcare organizations in need of personal protective equipment, ventilators, and other key resources would be connected to non-governmental organizations, government agencies and manufacturers to enable time-sensitive and need-based optimization of resource allocation and distribution. <br>Outcomes: We hope to facilitate near-real time tracking of resource consumption, to guide the efforts of rapidly emerging “pop-up” suppliers and manufacturers. This would ultimately feed into three key outcomes: a) to ensure immediate continuity of supplies to HCPs in the frontline against COVID-19; b) to track and preempt the trajectory of resource deficiencies and demands in order to mitigate the impact of the rapidly rising incidence of COVID-19 cases; and c) to establish a centralized network for healthcare specific e-commerce infrastructure in low-middle income countries to facilitate future crisis management. <br>Future Steps: We plan to expand iteratively, to include e-commerce technology to build our supplier dashboard and to develop a crisis specific e-commerce marketplace for healthcare resources.</p>
CommentaryCOVID-19Supply-chainPPELMICsDigital infrastructureKaleem Sohail AhmedAli Aahil NooraliAnam Noor EhsanMuhammad Huzaifa ZafarHumza ThobaniFaiza Urooj
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2023-07-242023-07-24333610.52314/gjms.2022.v2i1.23Naegleria fowleri in the United States and Across the Globe Amidst the COVID-19
https://www.thegjms.org/journal/index.php/gjms/article/view/42
<p>Naegleria fowleri, popularly known as the “Brain-eating Amoeba,” is an amphibolic, thermophilic, and free-living amoeba that thrives in freshwater streams and tolerates temperatures of up to 45 degrees Fahrenheit.1 Entering the brain via the nasal mucosa then the olfactory nerves, the organism reaches the cribriform plate, thus inducing a robust inflammatory response and generating cytotoxic enzymes, resulting in brain tissue destruction and necrosis, a lethal infection called Primary Amebic Meningoencephalitis (PAM). Naegleria fowleri also secretes pore-forming proteins (phospholipases and proteases), causing demyelination and immune system evasion. Those infected usually have a recent history of swimming, diving, or submersion, primarily in water streams, canals, or pools, and typically present with fever, nausea, headache, neck stiffness, and occasionally convulsions. Unfortunately, 95-97% of the cases result in death due to increased intracranial pressure and edema</p>
CommentaryJannel A LawrenceHarendra KumarSarosh SarwarMario MekhailArpit MagoMadeeha Subhan WaleedMona SheikhEfrain García
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2023-07-242023-07-24303210.52314/gjms.2022.v2i1.48Finding the Silver Lining of Opportunities through the Dark Clouds of COVID-19 Pandemic
https://www.thegjms.org/journal/index.php/gjms/article/view/41
<p>No single event so far has stumped the world more significantly than the present COVID-19 pandemic. However, every adversity brings with it an opportunity and as medical community, we must evolve in order to survive this unique challenge. This essay throws light on the various opportunities we can seize or have done so in the pandemic. We explore the opportunities in medical education and training, health research, clinical practices and frontline work, public health and awareness, and revenue generation and allocation of resources. Thus, through this article we understand that, “In every adversity lies an opportunity”, an age-old adage has never been truer than in the scenario of the current COVID-19 pandemic.</p>
PerspectiveCOVID-19OpportunitiesMedical EducationHealth ResearchClinical PracticePublic HealthResource AllocationPauras MhatreNandan MaratheSudeep Date
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2023-07-242023-07-24242910.52314/gjms.2022.v2i1.43Carbamazepine-Induced Symptomatic Bradycardia in a Middle-Aged Female
https://www.thegjms.org/journal/index.php/gjms/article/view/40
<p>Carbamazepine is an anticonvulsant drug commonly used to treat seizure disorders and trigeminal neuralgia. Although its hematological and hepatic side effects are well known, the rare cardiac side effects, mainly bradyarrhythmias, and atrioventricular blocks, are not discussed often in the literature. As per evidence, it has negative chronotropic and dromotropic effects on the cardiac conduction system. This case report discusses the life-threatening cardiac side effects of carbamazepine therapy and the significance of detailed cardiac evaluation before initiating this drug. We report a case of symptomatic bradycardia in a middle-aged female as the consequence of carbamazepine administration for seizure prophylaxis after meningioma resection.</p>
Case ReportCarbamazepineAdverse Effects of CarbamazepineCarbamazepine-Induced BradycardiaCardiac Arrhythmia,Atrioventricular BlockSourav SudanSneha Annie SebastianEdzel Co LorraineNavjot Kaur
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2023-07-242023-07-24202310.52314/gjms.2022.v2i1.51Invasive Candidiasis in a Case of Late onset Combined Immunodeficiency
https://www.thegjms.org/journal/index.php/gjms/article/view/39
<p>Late onset combined immunodeficiency (LOCID) is a recently described variant of common variable immunodeficiency (CVID), involving adult patients presenting with opportunistic infections and/or low CD4+ lymphocyte counts. We present a case of a 38-year, male, unmarried, who presented with history of abdominal pain and distension, jaundice and altered sleep- wake cycle suggestive of Decompensated liver disease. Patient developed multiple opportunistic infections in ward course which on further work up turned out to be Late onset combined immunodeficiency. Clinicians should be aware of LOCID, which could be confused with HIV infection/AIDS or idiopathic CD4 lymphocytopenia.</p>
Case ReportLate onset combined ImmunodeficiencyOpportunistic InfectionDevank ShahKaustubh Salagre
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2023-07-242023-07-24161910.52314/gjms.2022.v2i1.45Prevalence of Neurological Manifestations in Individuals Affected with Skeletal Fluorosis in Endemic Villages of Nalgonda District
https://www.thegjms.org/journal/index.php/gjms/article/view/38
<p>Background: <br>Fluorosis is a prevailing public health problem in many parts of the country. It is mainly caused by excessive intake of fluorides through drinking water. The effects are mainly on bones and teeth, producing skeletal and dental fluorosis respectively, which often are irreversible. Nalgonda district in Telangana state was known for highest fluorosis cases. So, we aimed to study the prevalence of headache, lethargy, impaired memory and insomnia and to determine the severity of these conditions.<br>Methodology: <br>A community-based cross-sectional study was conducted in Marriguda and narayanapuram mandals of Nalgonda district. 85 patients were recruited for the study. The data was collected using ‘Headache Impact Test-6 version 1.1’ for headache, ‘Regensburg Insomnia Scale’ for insomnia, ‘Fatigue Assessment Scale’ for lethargy and ‘Six Item Cognitive Impairment Test (6CIT)’ for impaired memory. <br>Results: <br>It was found that a total of 48.2% of individuals suffered from headache, 48.2% of individuals had insomnia, 57.6% of them complained of lethargy and 43.5% of them had impaired memory. Males were more prone to these manifestations except insomnia where females were more affected. <br>Conclusion:<br>Our study reported that the most prevalent neurological manifestation was lethargy and impaired memory is the least prevalent manifestation. Males were found to be more prone to developing these manifestations than females except in the case of insomnia. </p>
Original ResearchNeurological ManifestationsEndemicHeadacheInsomniaSreshta JeeluguPrasada Sharma MMV
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2023-07-242023-07-24111510.52314/gjms.2022.v2i1.49Substance use Pattern Analysis among Spanish Medical Students
https://www.thegjms.org/journal/index.php/gjms/article/view/37
<p>Background and objectives<br>Substance use and the increasing consumption of energy drinks are currently severe social health problems, and medical students are not an exception. <br>The study’s aims are to know the prevalence of different legal and illegal substances consumption among them (energy drinks included), and to evaluate different consequences and their aims for using them. Prevalence rates were compared to other national and international medical student samples and to general population of the same age range.<br>Methods<br>A cross-sectional descriptive study was carried out in 168 medicine students in Las Palmas de Gran Canaria who responded a survey on their substances use.<br>Results<br>Almost all of the study participants (162 (96.4%)) had ever tried/taken alcohol in their lifetime, 131 (78%) had consumed energy drinks, 109 (64.9%) had taken tobacco and 86 (51.2%) had taken cannabis. Main consequences included hangover 120 (71.4%), nausea or vomiting 100 (59.5%), and repenting of something done under the effect of substances 70 (41.7%). Looking for an improvement of their academic performance, 96 (57.1%) and 76 (45.2%) of medical students admitted having increased substance use and energy drinks consumption respectively.<br>Conclusions<br>The prevalence of alcohol, tobacco, cannabis, anxiolytics and amphetamines abuse is higher among medical students as compared to the general population. Energy drinks are widespread used (specifically higher for males). Almost half of medical students acknowledged having increased their consumption to improve test scores.</p>
Original ResearchSubstance-related DisordersMedical StudentEnergy DrinksPrevalence RateHealth ImpactGuillermo Pirez MoraMaria Rodriguez Ramón
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2023-07-242023-07-2431010.52314/gjms.2022.v2i1.33“Sleep Medicine: An Emerging Speciality”
https://www.thegjms.org/journal/index.php/gjms/article/view/19
<p>In a normal night’s sleep, a person goes through four stages of sleep cycle. These include one of rapid eye movement sleep (REM) and three of non REM (NREM) sleep. The NREM sleep further consists of three stages, stage 1 usually lasts for 1-5 mins and also termed as the ‘dozing off’ stage. As the person moves through further sleep cycle and goes into stage 2 of NREM that leads to muscle relaxation, drop in temperature and slow breathing and heart rate. Stage 2 sleep lasts for 10-25 minutes during the first sleep cycle and every N2 stage may become longer during the night. Overall, a person typically spends about half of his sleep time in N2 sleep. It is difficult to wake up a person from the N3 stage of sleep as it’s the deeper sleep as the muscle tone, pulse and breathing rate decrease further, brain activity in this stage shows delta waves and hence this is also called as delta sleep or slow wave sleep. This stage lasts for 20-40 mins in each sleep cycle. These stages keep on getting shorter further sending the person in REM sleep. During REM sleep, even though the eyes are closed, they can be seen moving quickly, hence the name. The body experiences atonia with two exceptions of the eyes and the muscles that control breathing. Under normal circumstances, a person does not enter REM sleep stage until for about 90 minutes after sleep.</p>
EditorialRukadikar Charushila
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2023-07-242023-07-241210.52314/gjms.2022.v2i1.60Psychiatric sequelae of COVID-19 - A Looming Mental Health Crisis
https://www.thegjms.org/journal/index.php/gjms/article/view/35
<p>The COVID-19 Pandemic laid a tremendous impact on the mental well being of all rungs of people, be it the general public, Covid- 19 survivors, health care and front line workers etc. It is not surprising to expect grave repercussions in the Post Covid period in the form of a rise in the number of people suffering from psychiatric illnesses.</p>
CorrespondenceNavya Sree VeldandaSuchita MylavarapuYatin Koushik Kundety
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2023-07-242023-07-24333410.52314/gjms.2021.v1i1.18Tracing the origin and nature of COVID-19 Delta variant
https://www.thegjms.org/journal/index.php/gjms/article/view/34
<p>The novel coronavirus disease has created havoc in the life of the general population. As of now, there are multiple SARS-CoV-2 virus variants enlisted in the Variant of Concern (VOC) and Variant of Interest (VOI) list which are spreading worldwide. One of these variant is detected in India in October 2020 which was further named as the B.1.617 lineage. The Delta variant, Lineage B.1.617.2, is considered to be more transmissible than contemporary lineages. Further, WHO named it the Delta variant on 31 May 2021, and on 11 May 2021, the WHO also classified this lineage as VOC. It was accounted that Public Health England (PHE) changed their order of classification of B.1.617.2 from Variant Under Investigation (VUI) to VOC dependent on an appraisal of contagiousness being essentially identical to B.1.1.7 on May 7, 2021.<sup>1 </sup> The variation is believed to be mostly liable for India’s second influx of pandemics starting in February 2021 and it later added to a third wave in the United Kingdom and South Africa. Moreover, in July 2021 according to WHO warning it was reported that it could have a comparable impact in Europe and Africa.<sup>2,3</sup> Till now 13 mutations of the Delta/B.1.617.<sup>2</sup> have been reported. Some of them are; Substitution of aspartate by glycine at position 614 causes D614G mutation on spike protein code which may responsible for high transmissibility and the substitution of leucine- by arginine at position 452 causes L452R mutation which presents a more affinity of the spike protein for the ACE2 receptor.<sup>4</sup> P681R mutation is the substitution of proline by arginine at position 681 which might increase cell level infectivity by working with cleavage of the S-precursor protein to the dynamic S1/S2 arrangement.</p>
CorrespondenceAbhishek Wahi Rishabh Solanki
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2023-07-242023-07-24313210.52314/gjms.2021.v1i1.4A Blueprint for Undergraduate Students to Work on Medical Cases
https://www.thegjms.org/journal/index.php/gjms/article/view/33
<p>Case reports refer to research designs that describe rare or unexpected observations in the clinical course of a single patient. They are valuable resources of novel information which may further lead to new research and advances in clinical practice. However, medical trainees are often unaware of the basic tenets, methodology and importance of presenting and reporting such unusual occurrences. They are also oblivious to the scope and significance of pursuing such endeavors in early days of their education. For undergraduate students, the experience of working on cases and publishing scientific manuscripts could prove vital in their understanding of scientific literature, while at the same time introducing them to world of medical research. This article provides a brief explanation of how students could begin their journey in this direction and develop a coherent understanding of Evidence Based Medicine</p>
CommentaryCase reportsMedical studentsCARE guidelinesAlhad Mulkalwar
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2023-07-242023-07-24273010.52314/gjms.2021.v1i1.7Pigmented Basal Cell Carcinoma Over Trunk: An Unusual Location
https://www.thegjms.org/journal/index.php/gjms/article/view/32
<p>Basal cell carcinoma (BCC) was first described by Jacob in 1827. It is also known as “ulcus rodens”. It is the most common type of skin cancer and accounts for approximately 80% of all the non-melanoma skin cancers. There are no precursor lesions described for BCC. In 80-85% of the cases, BCC most frequently develops over head and neck. Rarely, basal cell carcinoma has been reported over unusual non-sun-exposed locations such as axilla, groins, umbilicus, trunk, palm and soles. Only 10% of BCC are seen over trunk. BCC is rarely reported in childhood. We report a case of pigmented basal cell carcinoma in a 22-year-old female located on trunk, highlighting its dermoscopic, histopathological and immunohistochemistry findings.</p>
Case ReportPigmented Basal Cell CarcinomaDermoscopyTruncal Basal Cell CarcinomaAditi BansalSheerin shahAminder SinghAnkur Singla
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2023-07-242023-07-24232610.52314/gjms.2021.v1i1.12Senile Tumor in a Teenage Ovary - A Special Case Scenario
https://www.thegjms.org/journal/index.php/gjms/article/view/31
<p>In adolescence, ovarian cysts are a very prevalent gynaecological condition. The majority of ovarian cysts are benign, with only a few incidences of malignancy. In adolescents and teenagers, ovarian cystadenomas are uncommon. A 16 year old girl was complaining of acute stomach distension and pain. She received surgical removal and laproscopic drainage. Histopathology revealed that the lump was a serous cystadenoma. The goal of this case is to show that ovarian epithelial tumours, despite their rarity, should be included in the differential diagnosis of big ovarian masses.</p>
Case ReportOvarian Serous CystadenomaBenign Ovarian CystsTeenage GroupsGerm Cell TumoursEpithelial TumoursShvesh MozaAvijit Banerjee
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2023-07-242023-07-24202210.52314/gjms.2021.v1i1.21Disseminated Nocardiosis Masquerading as Metastatic Malignancy
https://www.thegjms.org/journal/index.php/gjms/article/view/29
<p>Nocardiosis is an uncommon Gram-Positive bacterial infection caused by aerobic Actinomycetes of the genus Nocardia. It can be localized or systemic and is regarded as an opportunistic infection that is commonly seen in immunocompromised patients. We report a case of disseminated Nocardiosis in a patient on immunosuppressant therapy in whom the clinical presentation was highly suggestive of a metastatic disease.</p>
Case ReportDisseminated NocardiosisMetastatic diseaseActinomycetesKiran Ahire Meghana VaidyaTanushree PadteVishal Gupta
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2023-07-242023-07-24151910.52314/gjms.2021.v1i1.27Fast Food and Soft Drink Consumption Pattern in Medical Students and its Association with Overweight and Obesity
https://www.thegjms.org/journal/index.php/gjms/article/view/27
<p>Background: Fast food and soft drink consumption is an increasing trend among young people and in medical students. Increased stress in life due to increased study load, have negative influences on the food choices of medical students. Hence present study was undertaken to know objectives of study fast food and soft drink consumption patterns in medical students, and to explore various factors contributing to fast food and soft drink consumption and to correlate patterns of fast food and soft drink consumption with overweight and obesity. <br>Materials & Methods: A cross sectional study was carried out during July 2020 to August 2020 where 198 undergraduate medical students were included in study. Pretested self-administrated semi structured questionnaire was used. analysis was done using Microsoft Excel 2013 and SPSS 16 version. <br>Results: Study showed 98%of respondents consume fast foods & soft drinks. Overweight prevalence is taken based on BMI, BMI> 25 was considered to be overweight, >30 was considered to be obese. Therefore 47%were affected to overweight. Among subjects who are affected with being overweight they consume Fast foods & soft drinks more frequently. The main Reason for consumption of fast food was mainly taste 58%, easily accessible 40%. <br>Conclusion: Despite the majority 95% aware of the fact that eating fast food may lead to many diseases, still all subjects continue to consume fast food , soft drinks mostly because of taste. </p>
Original ResearchFast foodSoft drinkMedical studentsOverweightObesityPatibandla GeethikaLavanya Yamani
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2023-07-242023-07-2491410.52314/gjms.2021.v1i1.22Retrospective Analysis of Patients Taking Anti-Koch’s Treatment (AKT) in Incidence of Tuberculosis in the Urban Population of South Gujarat
https://www.thegjms.org/journal/index.php/gjms/article/view/26
<p>Background: Tuberculosis (TB) continues to be a serious worldwide health issue, necessitating immediate effort to manage and eventually eradicate the disease. The current burden of TB in India is as high as that of more than 25% of all patients present globally are found in India, which means that it is double the amount of patients that are present in any other country. This makes India the most important focal point for any TB control Strategy and Gujarat is the state that has the most number of patients thus it is the representative of the TB both in terms of incidences as well as prevalence.<br>Aims and Objectives: To Study the incidence of tuberculosis in the urban area of South Gujarat and also identify the reasons for discontinuation of anti-Koch’s treatment (AKT).<br>Material and Methods: A retrospective and observational study was carried out in a South Gujarat tertiary care hospital. 500 patients suffering from pulmonary and extrapulmonary tuberculosis were recorded. The data were collected from the medical record department from 1st August 2018 to 31st July 2019 at a tertiary care health centre in South Gujarat. The ethics committee’s approval was taken before the start of the study. The data collected was analyzed in Microsoft Excel and the frequency of incidence and their percentages were calculated.<br>Results: In this study, it was observed that the majority of the affected patients, around 74%, lie within the age group of 21-30 years. Various forms of extrapulmonary tuberculosis have been included of which pleural effusion, tuberculosis lymphadenitis, abdominal tuberculosis were more prevalent. The reasons for the default of the patients as observed in this study were migration for work, AKT-induced side effects, feeling better, other medical conditions, and no improvement.<br>Conclusion: Most susceptible age group for developing tuberculosis is from 21-30 and males are seen to be more affected than females, so the default rate was also more in males as compared to females. Migration for work was the main reason among the defaulters. The incidence of pulmonary tuberculosis incidence was highest compared to the other types of tuberculosis. The second highest incidence of TB was of tubercular lymphadenitis with males and females having an almost equal percentage of Drug Resistant TB cases (MDR TB) was also recorded in some patients.</p>
Original ResearchTuberculosisExtrapulmonary tuberculosisMultidrug-resistant tuberculosis (MDR-TB)Anti-Koch’s Treatment (AKT)Shivangi PatelPawan Toshniwal
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2023-07-242023-07-244810.52314/gjms.2021.v1i1.15Resuscitation Medicine in Undergraduate Curriculum
https://www.thegjms.org/journal/index.php/gjms/article/view/25
<p>A fresh medical graduate posted as an intern in wards has the biggest fear of any patient needing cardiopulmonary resuscitation during his duty hours. He had listened to lectures on cardiopulmonary resuscitation (CPR) in his final year medicine posting, witnessed his seniors performing chest compressions, and also participated by doing some errand jobs (making phone calls, calling nurse, loading drugs) but he is always worried to face a similar situation all by himself as a first responder. The simulation course in CPR which is available under the newer guidelines of the National Medical Council (NMC) undergraduate curriculum is a group activity and it is very much possible that few students get left out in understanding the nuances of good CPR practice.</p>
EditorialAshima Sharma
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2023-07-242023-07-242310.52314/gjms.2021.v1i1.14Comment on: A Blueprint for Undergraduate Students to Work on Medical Cases
https://www.thegjms.org/journal/index.php/gjms/article/view/17
<p>I am writing to you in regard to the article titled ‘A Blueprint for Undergraduate Students to Work on Medical Cases’1 published in the Global Journal of Medical Students (Volume 1, Issue 1). The article highlights the importance and relevance of case reports in medical literature. However, a notification recently released by the National Medical Commission (NMC) of India seems to ignore the significance of the same. The NMC, in February 2022, published the ‘Teachers Eligibility Qualifications in Medical Institutions Regulations, 2022’2 which is the sixth such notification, since 2009, stating the promotional criteria for medical teachers. While the earlier documents simply mentioned ‘Research publications,’ the latest notifications explicitly states Original papers, Systematic reviews, Meta-analysis and Case series as the only published manuscripts to be considered for promotion.3 Thus, it clearly leaves out case reports from consideration for the same. This may disincentivize doctors in academic settings from reporting novel cases. The inclusion of case series in the list reflects that the reason for excluding case reports is not the diminished significance of unique cases, but the assumption that case reports are too small, quick or easy to publish. While case report may be a preliminary and shorter form of manuscript, it would be wrong to consider them as effortless endeavors. If the only concern regarding the inclusion of case reports in the list of publications to be considered for promotion was the length of the manuscript, requirement of the number of such publications could have been increased (for example, two case reports to be considered equivalent to one original article) instead of ignoring them altogether. Rare cases may not always be witnessed multiple times by the same physician to qualify for writing a case series. Thus, we may lose out on unique occurrences or findings which may have significant implications for clinicians.</p>
CorrespondenceAlhad MulkalwarSarita Mulkalwar
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2023-07-242023-07-24353610.52314/gjms.2022.v2i3.81Ramifications of Ukraine War on India based Ukraine Medical Students
https://www.thegjms.org/journal/index.php/gjms/article/view/16
<p>The ongoing war between Ukraine and Russia has blitzed several parts of Ukraine, leading to a humanitarian crisis. With the grim scenario of mounting casualties and increasing threat to the peoples’ lives, the Government of India has launched Operation ‘Ganga’, a prodigious evacuation plan for rescuing the Indian students stuck in Ukraine.</p>
CorrespondenceNovonil DebPoulami Roy
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2023-07-242023-07-24343410.52314/gjms.2022.v2i3.57Approach of Medical Students to Academic Research – The Futility of Crude Consequentialism
https://www.thegjms.org/journal/index.php/gjms/article/view/11
<p>The means-ends debate lies at the very core of the subject of ethics. However, instead of adopting a dichotomous, black-and-white attitude, it has been realized that one could pursue a goal oriented approach even without compromising on ethical standards. It would be prudent for students to inculcate such a balanced viewpoint in the formative years of medical education while pursuing their academic and co-curricular ambitions - being a part of research studies, for example. In order to extract the best of their experiences, students must not restrict their outlook to academic research merely as an addition to their résumés or just a task to be ticked off the to-do list. They should broaden their horizons and consider it as a privilege to be able to contribute to the profession and society even as young students of medicine.</p>
CommentaryMedical EthicsMisconductEducation,Human DignityProfessionalismAlhad Mulkalwar
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2023-07-242023-07-24313310.52314/gjms.2022.v2i3.80