Global Journal of Medical Students

Ramifications of Ukraine war on India based Ukraine medical students.

Novonil Deb — 2023-03-11

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Comment on: A Blueprint for Undergraduate Students to Work on Medical Cases

Alhad Mulkalwar — 2023-03-11

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.

Vacuum-assisted Closure Vs Conventional Open Treatment in Diabetic Foot Ulcer - A Comparative Study

Nirupam Nadella — 2023-03-11

Background: Vacuum-assisted closure (VAC) therapy also called negative pressure wound therapy (NPWT) is an emerging therapeutic option for diabetic foot ulcers. So, the current study intends to compare vacuum-assisted closure therapy and conventional open therapy in diabetic foot ulcers.

Methods: A prospective case-control study was conducted and 54 patients were randomly allotted into 2 groups during the study period. The cases group includes patients undergone VAC therapy and the control group includes patients undergone conventional open therapy.

Results: Patients in Group A had fewer positive wound cultures and secondary amputations as compared to Group B. VAC therapy was found to considerably improve the meantime to complete wound healing (24.22 days vs. 32.66 days). Secondary amputations were performed on 0% of patients in group A and 11.11 percent of patients in group B. The average hospital stay for group A was 20.33 days and 26.77 days for group B.

Conclusion: When compared to standard dressing, VAC treatment considerably lowers the time to complete wound healing, accelerates granulation tissue production, and reduces ulcer area. The VAC treatment group had no significant increase in bleeding or infection, according to the research.

Ensuring a Smooth and Hassle-Free Implementation of National Exit Test (NExT) exam: Feedback from a Pan-India online cross-sectional survey

Sushrut Ingawale — 2023-03-11

Abstract:

Background: The National Exit Test (NExT) exam is a proposed common entrance exam for both licensing to practice medicine and admission to postgraduate medical courses in India. Recently NMC published a draft for NExT Regulations to seek comments from the students, faculty and stakeholders. So, we aimed to assess the perception of MBBS students, graduates and medical faculty towards NExT Regulations to ensure a smooth and hassle-free implementation of NExT Exam.

Materials and Methods: A cross-sectional questionnaire based study was conducted online during January 2023. The study questionnaire included various types of questions: yes/no/maybe, single best response, likert scale and open ended questions pertaining to the specific points about the NExT draft. The questions were designed under the main domains of: (1) Participant characteristics, (2) General acceptance about NExT, (3) Feedback for NExT Step 1, and (4) Feedback for NExT Step 2.

Results: Of the 1412 participants, 873 (61.8%) participants felt that there was ‘No Need’ to replace the conventional theory exam. 895 (64.4%) participants preferred to have a single paper exam. 1141 (80.8%) opined that there should be ‘Single best response type Multiple choice questions (MCQs)’ only. Of the 1412 participants, 559 (39.6%) opined that the score should be valid only for 1 year and 550 (39%) opined it to remain valid for 3 years. 1042 (73.8%) participants felt there was No need for NExT Step 2.

Conclusion:

Though the implementation of NExT was planned with an intention to elevate the quality of medical education and bring a certain degree of uniformity across the nation, the policy level thought process did not fully percolate to the masses, especially students. The reasoning for the changes is not strongly supported by previous year data in the proposed draft. Therefore, there is a need to alleviate the anxiety among students about the NExT exam before implementing it. Based on our study we were able to give our suggestion to the proposed NExT draft.

A Case Study of Systemic Lupus Erythematosus in a Female Patient

Suvam Banerjee — 2023-03-11

Systemic Lupus Erythematosus (SLE) is the most common form of autoimmune disease which affects different systems of our body such as cardiovascular, nervous, respiratory, gastrointestinal, genitourinary, musculoskeletal, integumentary and immune systems. The most common patients’ complaints include problems with the skin, joints and kidneys. Symptoms vary from mild to severe, and if untreated, may result in lethal consequences. Currently, the onset of the disease is not known, and the cure for SLE is still to be found, but there exist various treatment options, which can support the patient in returning to normal life.
The importance of this case report lies in the fact that it is a very rare case, and hence can be of great clinical significance and source of learning for clinicians. This is quite a unique case which highlights the association of disease with its symptoms by comparing its possible differential diagnoses, management from the history of patients to diagnosis and the unique approach undertaken in treatment.
A 22-year-old female was hospitalized with the symptoms of angina, alopecia, oral ulcers and arthralgia. After extensive blood urinary analyses and renal biopsy, the patient was diagnosed with SLE. As for the final treatment decision, the patient was prescribed corticosteroids primarily for 6 months. During treatment, the condition of the patient has improved and during post-treatment, no follow-up complaints have been registered.
In summary, this case study might enhance the facility to report novel findings and better-quality therapeutic strategies. With quick, brief writing and publication rates, case studies are an essential tool for rapidly expanding the growing body of clinical knowledge.

First Case Report of COVISHIELD Vaccine Induced Pityriasis Rosea-like Eruption Following Second Dose

Ankur Singla — 2023-03-11

COVISHIELD vaccine, approved in India for restricted use in emergency situation is a recombinant, replication-deficient chimpanzee adenovirus vector vaccine. Various cutaneous adverse effects post-covishield vaccine have been reported so far. We report the case of a 36-year-old female, who presented with an itchy skin rash of 3 days duration over the trunk and bilateral upper limbs. On examination, there were multiple, small, violaceous papules with adherent scales, coalescing to form small plaques over the abdomen, back, bilateral arms, and thighs. She had received second dose of the covishield vaccine 8 days prior to the onset of the skin rash. Skin biopsy revealed hyperkeratosis, parakeratosis, hypogranulosis, and spongiosis of the epidermis along with dermal lymphohistiocytic infiltrate, and mild interface dermatitis, consistent with pityriasis rosea-like eruption. She was managed with oral antihistamines and topical steroids. To the best of our knowledge, this is the first case of pityriasis rosea-like eruption following the second dose of the Covishield vaccine, reported from India.

Acquired Bartter Like Syndrome in a Patient of Multi Drug Resistant Pulmonary Tuberculosis Secondary to Kanamycin Nephrotoxicity – A Case Report

Devesh Bhargude — 2023-03-11

India has the highest estimated burden of tuberculosis infection (TBI) globally caused by mycobacterial tuberculosis, with nearly 35-40 crores Indian population having TBI, of which 26 lakhs people (18-36 lakh) are estimated to develop Tuberculosis (TB) disease annually. An integrated and comprehensive ‘cascade of care’ approach and new advances in national tuberculosis elimination program have provided us with definitive management of tuberculosis infection and an active tuberculosis disease. Aminoglycosides are one of the cornerstones of drug resistant tuberculosis. Highly effective yet are very notorious for their dose dependent and independent nephrotoxicity. Our experience denotes a rare diagnosis of acquired Bartter like syndrome, in a 60-year man with pulmonary tuberculosis who received Kanamycin for a period of 5 months and subsequently presented with life threatening electrolyte imbalance. It also highlights the importance of adherence to the standard guidelines under National Tuberculosis Elimination Program (NTEP) and the importance of the routine monitoring of electrolytes in Multi-Drug Resistant Tuberculosis (MDR-TB) patients receiving treatment that includes Kanamycin.

Shifting the Healthcare Paradigm: The Promising Potential of Lifestyle Medicine

Tarun Kumar Suvvari — 2023-03-11

Dear readers, In this editorial we intended to bring your attention towards lifestyle medicine.

Concept Proposal for Nationalised Formative and Summative Assessments to Enhance the Preparedness of Medical Students for the National Exit Test (NExT) and Solution for Low Resource Countries: Insights from NBME Examinations in the USA

Satwik Kuppili — 2023-03-11

The National Exit Test (NExT) is planned to have a nationalised uniform assessment system for Indian medical graduates. This, being a new concept in India, the preparedness of students for such assessment needs to be under consideration. USMLE is a time-tested model in the United States of America. NBME test scores in the USA are intended for summative assessment of medical students and closely mimic the USMLE scores. We propose a model of nationalised formative and summative assessments as a preparedness tool for NExT that can be adapted by the NMC to have uniform and high-quality holistic assessment tools for Indian medical graduates.

Approach of Medical Students to Academic Research – The Futility of Crude Consequentialism

Alhad Mulkalwar — 2023-03-11

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.