• Users Online: 153
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Contacts Reader Login
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Access statistics : Table of Contents
   2017| November-December  | Volume 30 | Issue 6  
    Online since August 16, 2018

 
 
  Archives   Previous Issue   Next Issue   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Viewed PDF Cited
ORIGINAL ARTICLES
Status and trend of acute encephalitis syndrome and Japanese encephalitis in Bihar, India
Praveen Kumar, PM Pisudde, PP Sarthi, MP Sharma, VR Keshri
November-December 2017, 30(6):317-320
DOI:10.4103/0970-258X.239070  PMID:30117441
Background. Acute encephalitis syndrome (AES) is a clinical condition, of which the most common cause is Japanese encephalitis (JE). Though there is deficiency of data on AES and JE from Bihar, the state ranks third in the reporting of JE cases after Uttar Pradesh and Assam. We aimed to assess the status and trends of AES and JE cases in Bihar and to know the status of the disease in the districts. Methods. We collected monthly epidemiological data for AES and JE for the period 2009–2014. Results. A total of 4400 cases (733 cases/year) with an average case fatality rate (CFR) of 30% for AES for the entire study period. A total of 396 cases of JE were reported with approximately 14% CFR. The disease peaks were during the start and end of the Indian summer and monsoon months for AES and JE, respectively. Districts such as Patna, Jehanabad, Nawada, Gaya and East Champaran reported the maximum number of AES and JE cases with annual incidence rates of 4.7–25.0 and 0.546–1.78 per 100 000 population, respectively. Conclusion. Since 2009, the incidence of AES and JE cases has been increasing in Bihar.
  4,041 606 1
Mapping of health research funding in India
Lalit Dandona, Rakhi Dandona, G Anil Kumar, Krycia Cowling, Pritty Titus, Vishwa Mohan Katoch, Soumya Swaminathan
November-December 2017, 30(6):309-316
DOI:10.4103/0970-258X.239069  PMID:30117440
Background. We aimed to estimate the total annual funding available for health research in India. We also examined the trends of funding for health research since 2001 by major national and international agencies. Methods. We did a retrospective survey of 1150 health research institutions in India to estimate the quantum of funding over 5 years. We explored the Prowess database for industry spending on health research and development and gathered data from key funding agencies. All amounts were converted to 2015 constant US$. Results. The total health research funding available in India in 2011–12 was US$ 1.42 billion, 0.09% of the gross domestic product (GDP) including only 0.02% from public sources. The average annual increase of funding over the previous 5 years (2007–08 to 2011–12) was 8.8%. 95% of this funding was from Indian sources, including 79% by the Indian pharmaceutical industry. Of the total funding, only 3.2% was available for public health research. From 2006–10 to 2011–15 the funding for health research in India by the three major international agencies cumulatively decreased by 40.8%. The non-industry funding for non-communicable diseases doubled from 2007–08 to 2011–12, but the funding for some of the leading causes of disease burden, including neonatal disorders, cardiovascular disease, chronic respiratory disease, mental health, musculoskeletal disorders and injuries was substantially lower than their contribution to the disease burden. Conclusion. The total funding available for health research in India is lower than previous estimates, and only a miniscule proportion is available for public health research. The non industry funding for health research in India, which is predominantly from public resources, is extremely small, and had considerable mismatches with the major causes of disease burden. The magnitude of public funding for health research and its appropriate allocation should be addressed at the highest policy level.
  1,996 1,212 1
MEDICINE AND SOCIETY
Intraocular use of bevacizumab in India: An issue resolved?
Atul Kumar, Koushik Tripathy, Rohan Chawla
November-December 2017, 30(6):345-347
DOI:10.4103/0970-258X.239079  PMID:30117450
Bevacizumab is a monoclonal antibody against vascular endothelial growth factor (VEGF), which has been approved for intravenous use in certain cancers. There is evidence of its efficacy and safety as an intravitreal drug compared with ranibizumab and aflibercept. We have, in our practice, found it to be a cost-effective treatment option for ocular diseases, which could save a large amount of public money used in various national health insurance systems. An alert issued by the Drug Controller General of India led to a virtual ban on its intraocular use in India. However, pro-active advocacy and leadership by national ophthalmological societies helped to resolve the issue quickly.
  2,460 229 1
EDITORIAL
Evolving Paradigms of Personalized Medicine in Oncology
Kapil Dhingra
November-December 2017, 30(6):305-308
DOI:10.4103/0970-258X.239068  PMID:30117439
  1,190 1,042 -
REVIEW ARTICLE
Biological pacemakers: Concepts and techniques
Paurush Ambesh, Aditya Kapoor
November-December 2017, 30(6):324-326
DOI:10.4103/0970-258X.239072  PMID:30117443
The sinoatrial (SA) node is the dominant pacemaker of the heart which initiates the process of impulse generation in the cardiac tissue, thereby defining the rate and rhythm of cardiac contraction. The automaticity of the conduction cells in the SA node is due to ion channels which are inter-linked by molecular, histological and electrophysiological mechanisms causing spontaneous diastolic depolarization and generation of an impulse. The SA nodal action potentials are then transmitted to the ventricles by electrical coupling of the myocytes in different areas of the heart. Regulatory pathways overseeing cardiac impulse generation and conduction provide effective and safe pacing, and help maintain the rate according to the physiological demands of the individual's body. Failure of physiological pacing due to any pathology in the SA or atrioventricular node necessitates implantation of a permanent pacemaker. Implantable pacemakers, despite technological advances, are not without practical limitations including a defined battery life leading to lead and/or generator replacement at periodic intervals, vascular complications, occasional component failure, electronic interference from external/ internal sources, e.g. myopotentials, electromechanical interference, etc., inadequate or incomplete physiological rate response to autonomic influences (devices have certain algorithms to address these issues) and most importantly the risk of infection. A biological pacemaker is therefore emerging as a promising technique to counter these challenges.
  1,604 422 1
CLINICAL CASE REPORT
Terbinafine-induced liver injury
Madhu Kaushal, Priyanka Tolani, Navneet Kumar, Shiwani Sharma
November-December 2017, 30(6):321-323
DOI:10.4103/0970-258X.239071  PMID:30117442
Terbinafine is a common antifungal agent with few reports of liver injury. We present a 64-year-old man who developed terbinafine-induced liver injury. Drug-induced liver injury is an important cause of morbidity and an early diagnosis may prevent progression to severe and chronic forms of liver injury including fulminant hepatic failure.
  1,358 253 2
SELECTED SUMMARIES
People with tuberculosis falling through the cracks
Matthew Murrill, Yogesh Jain, Sushil Patil
November-December 2017, 30(6):329-331
DOI:10.4103/0970-258X.239075  PMID:30117446
  1,092 133 -
MEDICAL EDUCATION
Identifying core competency areas to assess communication skills among interns at a tertiary teaching hospital in southern India
Asma A Rahim, PM Anitha, Geeta M Govindaraj, KV Laila
November-December 2017, 30(6):332-336
DOI:10.4103/0970-258X.239076  PMID:30117447
Background. We aimed to develop a teaching–learning and evaluation programme on communication skills for interns. Core competency areas for focused communication skills training and assessment were identified to achieve the obective. We then assessed the identified competencies among interns using objective structured clinical examination (OSCE), before the start of internship. Methods. Five core areas for focused training and evaluation were identified on the basis of responses of practising physicians in local settings. OSCE stations were developed for evaluation based on the identified competency areas. A pre-test OSCE was administered to 30 interns. Results. Five core areas selected for training and evaluation were: (i) communicating with a parent resistant to immunization; (ii) interacting with a patient who has psychosomatic complaints; (iii) explaining risks and procedures; (iv) breaking bad news; and (v) communicating with patients and bystanders in a casualty setting. Thirty of 160 interns were selected to participate in the OSCE before the training (pre-test). The lowest score was for breaking bad news. Scores indicated that explaining risks and procedures, communicating in a busy casualty setting and dealing with psychosomatic complaints were areas that required extensive training and practice. Conclusions. We were able to identify core competency areas for focused training and evaluation of communication skills suited to the local context and used OSCE to evaluate the skills before the start of internship.
  762 183 -
Effect of vestibular stimulation on spatial and verbal memory in college students
Sai Sailesh Kumar, R Archana, JK Mukkadan
November-December 2017, 30(6):337-339
DOI:10.4103/0970-258X.239077  PMID:30117448
Background. Excessive stress may have an adverse effect on learning and memory of students. It was reported that stimulation of the vestibular system enhances memory through its connections with the hippocampus, limbic system and neo cortex. This study aims to assess the effectiveness of vestibular stimulation in the modulation of memory in healthy human subjects. Methods. For this longitudinal follow-up study, we assessed spatial and verbal memory of participants followed by vestibular stimulation. A total of 240 healthy college students of 18–24 years, of either sex were selected after obtaining written consent from them. Participants were randomly assigned into four groups—control male and female group and vestibular male and female groups. Vestibular stimulation was administered by making the participants swing on a swing, according to their comfort (back to front direction) as standardized by previous methods. Spatial and verbal memory tests were used to assess memory. Data were analysed using two-way ANOVA followed by the Bonferroni post-hoc tests to compare differences between groups. Results. Baseline values of spatial and verbal memory scores were not significantly different between the control and intervention groups. Significant enhancement was observed in spatial memory following vestibular stimulation in males but not female subjects. Contrary to this, significant decrease in spatial memory was observed in both males and females due to pre-examination stress who did not receive any vestibular stimulation. Significant enhancement was observed in verbal memory scores in both males and females who received vestibular stimulation, whereas verbal memory was significantly decreased in males and females in the control groups during the pre-examination period. Conclusion. Our study provides evidence to support vestibular stimulation as an efficient method to enhance memory and to prevent pre-examination associated stress-induced changes on memory. We recommend vestibular stimulation as a simple approach to improve verbal memory among students to cope with their pre-examination stress.
  719 165 1
MEDICINE AND SOCIETY
Clinical research training and capacity building for prevention and control of non-communicable diseases: A programme in India
Viswanathan Mohan, O Dale Williams, Sundarapandi Chella, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Sudha Vidyasagar, Prasanta Kumar Bhattacharya, Nayanjeet Chaudhury, Anand Krishnan, Stephanie Garcia, Cora E Lewis, Myron Gross, Rajendra Pradeepa
November-December 2017, 30(6):340-344
DOI:10.4103/0970-258X.239078  PMID:30117449
Background. Non-communicable diseases (NCDs)—a term which includes diabetes, cardiovascular disease, cancers, chronic respiratory diseases, and mental illness—are now the major cause of death in India and pose healthcare and economic challenges. There is an urgent need for enhanced clinical research training and capacity building for NCD prevention and control in India. Methods. We describe a multi-pronged approach funded in part by the US National Institutes of Health Fogarty International Center, which was initiated in 2001, to train Indian present and future scientists/doctors in NCD prevention and control. The approaches used were annual national seminars, intensive training courses, in-house workshops, short-term training sessions in the USA and monthly video conferences. Results. During 2001–2016, a total of 3650 undergraduate, postgraduate and faculty from medical colleges and institutes from almost all states in India and several neighbouring countries participated in seminars and other capacity-building workshops held at the Madras Diabetes Research Foundation, Chennai and at six other medical colleges; 883 delegates participated in the in-house workshops, 463 in the intensive interactive sessions; 244 in workshops on advanced techniques in genomics; and 37 in short-term training sessions held in the USA. Conclusion. Through this unique capacity-building programme, more than 5000 individuals representing faculty and students from various medical colleges and research institutes across, and beyond, India, underwent training in the prevention and control of NCDs.
  702 146 2
SPEAKING FOR MYSELF
Errors of inclusion and exclusion in income-based provisioning of public healthcare: Problems associated with below poverty line cards
Vikas Bajpai, Namrata Singh, Hardik Sardana, Sanjana Kumari, Beth Vettiyil, Anoop Saraya
November-December 2017, 30(6):348-351
DOI:10.4103/0970-258X.239080  PMID:30117451
This study examined the effect of out-of-pocket expenditure of patients on their illness and other household changes impacting on their well-being, and assessed the socioeconomic status and below poverty line (BPL) card status among patients at the All India Institute of Medical Sciences, New Delhi. We did a hospital-based cross-sectional study of 374 inpatients and outpatients. Among the 374 study subjects, more than 69% of poor did not possess a BPL card. On the other hand, 5.5% of the above poverty line patients among the respondents possessed a BPL card. Of those having BPL cards, 84.4% belonged either to the lower middle, upper lower and lower socioeconomic status categories. Our data suggest that the inaccuracies in providing BPL cards limit access of the genuine poor to healthcare. In the light of national-level surveys on accessing healthcare and out-of-pocket expenditure by patients there is a case against ‘targeting’ in the delivery of public health services and user charges have an adverse impact on access to healthcare by the poor.
  715 92 -
SELECTED SUMMARIES
Insecticide-treated bednets for prevention of malaria
Olivia Marie Jacob, Ravneet Kaur
November-December 2017, 30(6):328-329
DOI:10.4103/0970-258X.239074  PMID:30117445
Steinhardt LC, Jean YS, Impoinvil D, Mace KE, Wiegand R, Huber CS, Alexandre JSF, Frederick J, Nkurunziza E, Jean S, Wheeler B, Dotson E, Slutsker L, Kachur SP, Barnwell JW, Lemoine JF, Chang MA. (Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Atlanta, GA, USA; Programme National de la Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince; Division of Global Health Protection, Centers for Disease Control and Prevention, Port-au-Prince; and Population Services International, Port-au-Prince, Haiti.) Effectiveness of insecticide-treated bednets in malaria prevention in Haiti: A case–control study. Lancet Glob Health 2017;5:e96–e103.
  623 118 -
Cisplatin-induced hearing loss in children with cancer
Bivas Biswas, Sandip Ganguly, Joydeep Ghosh, Atul Batra
November-December 2017, 30(6):327-328
DOI:10.4103/0970-258X.239073  PMID:30117444
  563 163 2
IMAGES IN MEDICINE
Mediastinal haematoma: A rare complication of central venous catheter insertion
Syed Rizwan Ali, Dhruvika Mukhija, Sajan Jiv Singh Nagpal
November-December 2017, 30(6):362-362
DOI:10.4103/0970-258X.239090  PMID:30117456
  524 119 -
CORRESPONDENCE
Students' perceptions of gaps in teaching communication skills and behavioural sciences in undergraduate dental education
Varsha Murthy, KR Sethuraman, Sunayana Choudhury, R Shakila
November-December 2017, 30(6):363-364
DOI:10.4103/0970-258X.239091  PMID:30117457
  485 103 -
LETTER FROM CHENNAI
Letter from Chennai
MK Mani
November-December 2017, 30(6):352-353
DOI:10.4103/0970-258X.239081  PMID:30117452
  504 76 -
BOOK REVIEWS
Inguinal Hernia Surgery
Mahesh C Misra
November-December 2017, 30(6):358-359
DOI:10.4103/0970-258X.239086  
  485 81 -
MASALA
Masala
Vivek Arya
November-December 2017, 30(6):367-367
DOI:10.4103/0970-258X.239095  
  451 115 -
BOOK REVIEWS
India's Indigenous Medical Systems: A cross-disciplinary approach
Sarika Chaturvedi, Bhushan Patwardhan
November-December 2017, 30(6):360-360
DOI:10.4103/0970-258X.239087  
  492 66 -
LETTER FROM BRISTOL
Letter from Bristol
Catherine Graham, Dheeraj Rai
November-December 2017, 30(6):356-357
DOI:10.4103/0970-258X.239083  PMID:30117454
  372 71 -
LETTER FROM GLASGOW
Letter from Glasgow
Harpreet S Kohli
November-December 2017, 30(6):354-355
DOI:10.4103/0970-258X.239082  PMID:30117453
  332 63 -
BOOK REVIEWS
The Secret Life of Zika Virus
Reeta S Mani
November-December 2017, 30(6):361-361
DOI:10.4103/0970-258X.239089  
  325 63 -
Sick Kids Handbook of Pediatric Thrombosis and Hemostasis
Tulika Seth
November-December 2017, 30(6):358-358
DOI:10.4103/0970-258X.239085  
  306 68 -
NEWS FROM HERE AND THERE
News from here and there

November-December 2017, 30(6):365-366
DOI:10.4103/0970-258X.239092  
  254 72 -
BOOK REVIEWS
New Directions in Geriatric Medicine: Concepts, trends, and evidence-based practice
AB Dey
November-December 2017, 30(6):360-361
DOI:10.4103/0970-258X.239088  
  176 65 -