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REVIEW ARTICLES
A theoretical review of psychological resilience: Defining resilience and resilience research over the decades
Shae-Leigh Cynthia Vella, Nagesh B Pai
July-December 2019, 7(2):233-239
DOI
:10.4103/amhs.amhs_119_19
Recent times have seen a shift in interest from a focus upon the deficits of individuals to a focus upon individual's strengths. Resilience is a positive psychology construct that has been investigated for decades, prior to this paradigm shift. This article reviews definitions of resilience over time. Although there is no single agreed definition; resilience is commonly described as the ability to bounce back. The risk of stress and negative life events in triggering mental illness has long been recognized. Similarly, the positive outcomes of some individuals to highly adverse situations have also been of interest for a long time. These positive responses or outcomes in the face of significant risk or adversity are generally known as resilience. This article provides a review of definitions of resilience and resilience related phenomena as well as a historical review of the focus of resilience research across the decades in order to inform future research and theorizing. The article concludes with recommendations to researchers to explicitly define their definition and conceptualization of the construct as well as the imperative to move towards a unified view of the construct of resilience. Further, it is clear that research on resilience has progressed and evolved over the decades however this does not denote that research in the area is complete. As such researchers should still seek to understand the complexities of resilience, how to build resilience in different populations, or in individuals experiencing similar adversities.
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Neuropharmacological classification of antidepressant agents based on their mechanisms of action
Olumuyiwa John Fasipe
January-June 2018, 6(1):81-94
DOI
:10.4103/amhs.amhs_7_18
The currently available clinical antidepressants can be classified into 13 different classes based on their mechanisms of action. These basic pharmacological concepts thoroughly elucidate and unravel the therapeutic actions and side effects of the wide range of antidepressants currently available. The two classical mechanisms are exhibited by tricyclic antidepressants (TCAs) and by monoamine oxidase inhibitors (MAOIs). Regarding the 11 relatively nonclassical antidepressants, the most widely prescribed agents are the selective serotonin reuptake inhibitors (SSRIs). The mechanisms of action for the other classes of antidepressants that exhibit additional actions on serotonergic neurotransmission are dual serotonin-norepinephrine reuptake inhibition (SNRI), serotonin receptors antagonism with serotonin reuptake inhibition (SARI), serotonin 5-HT
1A
autoreceptor partial agonism with serotonin reuptake inhibition (SPARI), serotonin-norepinephrine reuptake inhibition and serotonin receptors antagonism antidepressant with potent antipsychotic D2 receptor blockade/antagonism (SNRISA with potent antipsychotic D2 receptor blockade/antagonism), norepinephrine reuptake inhibition with serotonin receptors antagonism (NRISA), noradrenergic α
2
-receptor antagonism with specific serotonergic receptors-2 and-3 antagonism (NASSA), and atypical antipsychotics that exhibit weak D
2
receptor antagonism with potently strong 5-HT
2A
receptor blockade. Furthermore, the two classes that exhibit selective norepinephrine reuptake inhibition (NRI) and dual norepinephrine-dopamine reuptake inhibition (NDRI) define separate novel classes of antidepressants that have a direct action on the noradrenergic neurotransmission system but have no direct action on the serotonergic neurotransmission system, while the last remaining one class of N-methyl-D-aspartate-glutamatergic ionoceptor antagonist/inverse agonist/partial agonist also represents a separate novel class of antidepressants with a direct action on the excitatory glutamatergic neurotransmission system but no direct action on the serotonergic, noradrenergic, or dopaminergic neurotransmission systems. Lastly, this review remarkably advocates for the incorporation of the atypical antipsychotics and NMDA-glutamatergic ionoceptor antagonist/inverse agonist/partial agonist as new member classes of the antidepressant agents because of their clinically significant roles in the management of depression disorders.
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SPECIAL ARTICLES
Moving toward competency-based education: Challenges and the way forward
Thomas V Chacko
July-December 2014, 2(2):247-253
DOI
:10.4103/2321-4848.144365
This article aims at giving a broad overview on competency-based education to those who are currently in the predominantly knowledge focused discipline-based curriculum and so are uninitiated to the competency-based educational paradigm. This is done by taking them through the curricular trends in medical education that have happened elsewhere in the world and providing them with a gist of what is competency-based medical education, how it is different from the earlier paradigms of instruction, the advantages that this paradigm of mastery learning presents to help the learner acquire competencies needed for doing the professional tasks and duties that are in alignment with health needs of the country, the framework and the broad steps involved in its implementation, the challenges that its implementation presents particularly with regard to benchmarking for assessment as revealed by the experiences in the Western world that resulted in a three-decade lag between intention to change and actual change and the way forward to overcome these challenges particularly through faculty capacity-building using longitudinal faculty development programs or series of faculty retreats to ensure that it can be successfully implemented and sustained to serve the purpose of producing job-ready professionals.
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MEDICAL EDUCATION
Perceived stress among medical students: To identify its sources and coping strategies
Shubhada Gade, Suresh Chari, Madhur Gupta
January-June 2014, 2(1):80-86
DOI
:10.4103/2321-4848.133845
Context:
Stress in medical education is common and process-oriented. It often exerts a negative effect on their academic performance, physical health, and psychological well being.
Aims:
This study aims at identification of such susceptible students in the early stage i.e. first year of medical education, and to provide them essential support in the form of an intervention program to lessen the negative consequences of stress.
Materials and Methods:
A cross-sectional survey was carried out among the First MBBS students of NKP Salve Institute of Medical Sciences and Research Center, Nagpur, India. A 41-item questionnaire was designed to assess the sources of stress and their severity. Likert's 5-point scale was used to quantify the extent of severity on each item. Coping strategies adopted by students were assessed by using a 22-item stress inventory, and a questionnaire based on 19 institutional stress-reducing factors was used to identify its role.
Results:
The survey resulted into an overall response rate of 87% (131 out of 150 students). Median stress level based on 41 items was evaluated for each student. About 29% (40 students) had median stress level greater than 3. Female students were more stressed (17.19%) than male students (14.93%). The study revealed that students generally adopt active coping strategies rather than avoidant strategies like alcohol and drug abuse. The study indicated that emotional support system is a major stress-relieving factor for students.
Conclusion:
Prevalence of perceived stress is high among medical students. It seems that academic-related problems are greater perceived stressors. Review of academics, exam schedules and patterns, better interaction with the faculty and proper guidance, intervention programs and counseling could certainly help a lot to reduce stress in medical students.
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REVIEW ARTICLES
Is maternal age risk factor for low birth weight?
Radha Y Aras
January-June 2013, 1(1):33-37
DOI
:10.4103/2321-4848.113558
Low birth weight (LBW) is a significant public health concern at global level. LBW is the outcome of interplay of multiple maternal factors. Maternal age is an important variable leading to LBW and preterm births. The literature review was done with extensive search from Medline, the Educational Resources Information Center, and the Combined Health Information Database for publications that identified the studies related to maternal age and birth weight. With exception of few studies which concluded that age did not significantly affect birth weight of newborns, majority of research indicated that a very young maternal age is causally implicated with an increased risk of having LBW and preterm births. Little research has been conducted on births to older mothers, even though such births are becoming increasingly common in developed countries. Advancing maternal age is associated with a decreased potential for fetal growth, possibly reflecting biological aging of maternal tissues and systems or the cumulative effects of disease. Results of multivariate analysis showed a U-shaped relationship between maternal age and LBW among whites, with the youngest (younger than 15) and the oldest (aged 40 and older) mothers being at high risk than 25-29 years old; older teenagers were not at any significantly higher risk. For the black, the risk of LBW rose steeply with maternal age (mothers aged 15-19 years are significantly lower risk than those of 25-29 years for LBW infants).
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ORIGINAL ARTICLES
Prevalence of prediabetes and its associated risk factors among rural adults in Tamil Nadu
Logaraj Muthunarayanan, Balaji Ramraj, John Kamala Russel
July-December 2015, 3(2):178-184
DOI
:10.4103/2321-4848.171899
Background:
Considerable number of people in the prediabetic stage will go on to develop type 2 diabetes. Early diagnosis and intervention of prediabetic and their cluster of risk factors can prevent the cardiovascular events and other complications of diabetes.
Objectives:
To estimate the prevalence of prediabetes and associated factors among adults attending fixed mobile clinic in a rural block in Tamil Nadu.
Materials and Methods:
A cross-sectional study was carried out among 544 individuals over the age of 20 years through our fixed mobile clinic among 30 villages of a block in Tamil Nadu with a structured interview schedule.
Results:
A total of 544 participants above the age of 20 years were studied of which 72.6% were women and 27.4% were men. The prevalence of prediabetes was 8.5% and diabetes was 10.1%. Higher risk of being prediabetic and diabetic was noted above the age of 40 years (odds ratio [OR] = 7.79, 2.17), male gender (OR = 1.46, 2.34), body mass index of more than 23 kg/m
2
(OR = 1.52, 2.13), waist hip ratio of men >1 and women >0.8 (OR = 1.49, 2.28), alcohol intake (OR = 1.59, 2.45), and systolic blood pressure of more than 140 mm of Hg (OR = 2.23 and 2.15).
Conclusion:
Identifying people with prediabetes and creating awareness on the prevention of diabetes by lifestyle modification and development of cost-effective strategy to prevent or delay the progression of the prediabetic stage to diabetic stage is the need of the hour for the prevention of diabetes in country like India.
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SPECIAL ARTICLES
Emerging pedagogies for effective adult learning: From andragogy to heutagogy
Thomas V Chacko
July-December 2018, 6(2):278-283
DOI
:10.4103/amhs.amhs_141_18
Understanding the way the student learns effectively is important for teachers so that they can then more effectively design their learning experiences. As the student in the health profession education progress across the long period and phases of learning from being an advanced beginner in a wider range of competencies during Undergraduate (UG) to becoming proficiently competent in areas of their specialization during their Postgraduate (PG) period and then after professional specialization while engaging in learning for expertise on-the-job during early professional development, they transition from a low learner maturity phase to full learner autonomy where they determine what and how to learn. Whereas pedagogy with high degree of teacher control matches low learner maturity, as the learners become more autonomous, teachers face the dilemma about how much they need to let go of their power and control to transition from “sage-on-stage” to “guide-on-the-side”. This article examines some of these dilemmas and attempts to suggest use of effective pedagogies (teaching methods) that match the transition of the adult learner engaged in the art and science of healing and progressing through the professional course's stages of competence progression from being a novice to a competent professional and after their formal professional qualification to help them reach expertise and improve quality of care by engaging in continuing professional development (CPD). This knowledge about learner maturity and adult learning principles will also help diagnose and address learner's problems and obstacles to effective learning that is happening at the institutional level.
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MEDICAL EDUCATION
Cinemeducation: Facilitating educational sessions for medical students using the power of movies
P Ravi Shankar
January-June 2019, 7(1):96-103
DOI
:10.4103/amhs.amhs_30_19
Medical education focuses predominantly on the science of medicine neglecting the arts and human relationships. Medical humanities was developed to provide a “differing” perspective of the arts. Movies play an important role in the medical humanities and have been used to address various subjects such as medical ethics, doctor–patient relationship, clinical research, mental illness, and professionalism during medical school. Movies involve the affective domain, promote reflection, and link learning to experiences. Movies can teach empathetic behaviors, self-reflection, compassion, and other skills. Movies have been used in a variety of disciplines such as family medicine, psychiatry, internal medicine, and clinical pharmacology among others. Faculty should identify possible topics where movies can be used. Then, they have to create a shortlist of suitable movies and identify the movie to be screened. A list of suitable activities and exercises to promote critical analysis and reflection should be created. Before the screening, a brief introduction to the movie can be provided. The screening should be followed by group activities, presentations, and facilitator inputs. Movies have been used to address topics such as domestic violence, cultural medicine, and attitude toward chronic illness. Most published reports about the use of movies are from the USA. Reports from Canada, Europe, and Argentina are also common. Movies have been used in some Caribbean medical schools and are being increasingly used in South Asian medical schools. A variety of instruments can be used to obtain feedback. There are various databases and collections which will be helpful in choosing appropriate movies.
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Perception of medical students on e-assessment conducted through Yengage portal
Latha Rajendra Kumar, Aafiya Bedra, Rajesh Karkera
January-June 2013, 1(1):61-66
DOI
:10.4103/2321-4848.113577
Introduction:
E-learning includes various categories of media that distribute text, audio, images, animation, and streaming video, and includes technology applications and processes, computer-based learning, as well as local intranet/extranet learning. Information and communication systems motivate many e-learning processes. E-learning can occur in or out of the classroom. ILIAS (Integriertes Lern-, Informations- und Arbeitskooperations-System [German for "Integrated Learning, Information and Work Cooperation System"]) is an open source web-based learning management system (LMS). It supports learning content management and tools for collaboration, communication, evaluation, and assessment for University students.
Materials and Methods:
First year medical students were requested to register in Yengage, and the date of the assessment was announced. Twenty MCQ from cardiovascular system was preloaded in the Yengage portal, and the students used their personal laptop to answer the questions within the stipulated time. The results were automatically loaded at the end of the assessment. Pre- and post-test was conducted to investigate the usefulness of the E- assessment.
Results:
The students responded that the E-assessment was easy to assess, unique as they received immediate feedback, customized and flexible. There was significant difference in the post-test score when compared to the pre-test score.
Discussion:
Technology has created new methods of assessment for today's generation of students, and these advances are here to stay.
Conclusion:
It is possible to conduct online examinations in medical school regularly. The e-learning can enhance student interests and allows immediate feedback. Since e-learning is not well-established in India, we hope to create awareness and change the outlook of medical students in online teaching-learning and assessment program.
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SPECIAL ARTICLES
Magnets in dentistry
Vidya S Bhat, K Kamalakanth Shenoy, Priyanka Premkumar
January-June 2013, 1(1):73-79
DOI
:10.4103/2321-4848.113587
Magnets have generated great interest within dentistry. They have been used for various applications in orthodontics and prosthodontics. Earlier use of magnets was limited due to the unavailability of small size magnets, but after the introduction of rare earth magnets and their availability in smaller sizes, their use has increased considerably. They can be placed within prostheses without being obtrusive in the mouth. Their main use in orthodontics has been for tooth movement and in prosthodontics has been in maxillofacial prosthesis and in overdentures as retentive aids. This article reviews the types of magnets available and their application in maxillofacial prosthesis and overdentures, followed by other advantages and disadvantages.
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Epidemic of difficult-to-treat tinea in India: Current scenario, culprits, and curbing strategies
Manjunath M Shenoy, Jyothi Jayaraman
January-June 2019, 7(1):112-117
DOI
:10.4103/amhs.amhs_72_19
Dermatophytes cause superficial skin infections of skin, nail, and hair known as dermatophytosis. It is commonly called as “ring worm” infection. There has been an emergence of an epidemic of recurrent and chronic dermatophytosis in India. Several reasons have been implicated that are related to the agent, host, and the treatment. Topical steroid misuse has been considered as an important contributor that has led to the persistence and atypicality of the infection. This article emphasizes on the salient features of the current dermatophyte epidemic to sensitize all physicians who treat the infections.
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ORIGINAL ARTICLES
Awareness, practices, and prevalence of hypertension among rural Nigerian women
Samuel O. Azubuike, Rahab Kurmi
January-June 2014, 2(1):23-28
DOI
:10.4103/2321-4848.133791
Background:
High blood pressure is on the rise globally, affecting more women than men in many developing countries. It is the leading cause of mortality worldwide, and hospitalization in sub-Saharan Africa. Many known risk factors to hypertension, though prevalent in Nigeria, are controllable. Prevention, however, is difficult where there is poor awareness, attitude, and practices.
Objectives:
The study aims at determining the level of knowledge of hypertension and its associated factors, attitudes, practices, and prevalence among rural Nigerian women.
Materials and Methods:
Cross-sectional design was used to study 252 subjects in Sanga Local Government Area. Subject selection was by purposive and stratified sampling techniques. Data were collected using self-administered, semi-structured questionnaire after informed consents were obtained both verbally and in writing. Data were analyzed using SPSS statistical package. Level of significant was taken at 0.05.
Results:
Prevalence of hypertension was 24.2%. Average level of risk factor awareness was 65.4% with excessive salt intake (77.4%) being the most recognized. Asymptomatic nature of hypertension was recognized by 61.5% of the respondents, while 44.4% only knew the standard method for hypertension detection. While 17.5% strongly believed that hypertension can be managed effectively with drugs, it was only 9.1% that strongly disagreed that it could be caused by evil spirits. The average number of those with good preventive life style practices was 61.3%. Knowledge was associated with several factors and seems to affect practices (
P
< 0.05).
Conclusion:
Fair but inadequate level of knowledge and attitudes affected by several factors, as well as moderately high prevalence was recorded.
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The effect of regular physical exercise on the thyroid function of treated hypothyroid patients: An interventional study at a tertiary care center in Bastar region of India
Akash Bansal, Amit Kaushik, CM Singh, Vivek Sharma, Harminder Singh
July-December 2015, 3(2):244-246
DOI
:10.4103/2321-4848.171913
Background:
Thyroid hormone is a key substance in normal homeostasis, having variable influence on cell metabolism on different organs. Hypothyroidism is common, potentially serious, often clinically overlooked, readily diagnosed by laboratory testing, and eminently treatable.
Aim:
This study was conducted with the aim of finding the effect of regular physical exercise of medium-intensity on thyroid function in patients already undergoing treatment for hypothyroidism.
Materials and Methods:
A total of 20 ambulatory treated hypothyroid patients were included in the study. Serum samples were collected and evaluated for triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) both before and after 3 months of daily 1 h physical exercise, from those patients doing exercise and from those who did not do any physical exercise.
T
-test was used to find a significant difference between the two groups.
Results:
Serum TSH was found to be significantly decreased in patients of regular exercise group postinterventionally (
P
< 0.001) when compared with nonexercise group (
P
= 0.43). Serum T3 and T4 were also found to be significantly raised in regular exercise group postinterventionally (
P
= 0.007 and
P
< 0.001 respectively) but not in nonexercise group (
P
= 0.92 and
P
= 0.73 respectively). On inter group comparison significant decrease in TSH was found in regular exercise group (
P
= 0.002) and significant increase was found in levels of T3 (
P
= 0.002) and T4 (
P
= 0.001) in regular exercise group. Mean weight was also found to be decreased in regular exercise group postinterventionally.
Conclusion:
Every hypothyroid patient should do regular physical exercise along with thyroxine replacement to improve thyroid function.
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CASE REPORTS
Kissing molars: An unusual unexpected impaction
Parveen Shahista, Rohan Mascarenhas, Sandeep Shetty, Akhter Husain
January-June 2013, 1(1):52-53
DOI
:10.4103/2321-4848.113570
Impacted molars have been widely reported. However, kissing molars is a rare finding which refers to impacted molars which have occlusal surfaces contacting each other in a single follicular space and roots pointing in opposite directions as reported in this case. This is the second case of kissing molars involving third and fourth molar and the only case fulfilling the criteria of kissing molars.
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539
ORIGINAL ARTICLES
A study of morphometric evaluation of the maxillary sinuses in normal subjects using computer tomography images
Lakshmi N. Kiruba, Chandni Gupta, Sandeep Kumar, Antony S. D'Souza
January-June 2014, 2(1):12-15
DOI
:10.4103/2321-4848.133782
Objectives:
The paranasal sinuses are complex anatomical structures with a significant inter-individual variation. The dimensions of maxillary sinuses are particularly significant when considering endoscopic sinus surgery
.
The aims of this study were to estimate different dimensions of the maxillary sinuses measured on head CT, and their relations to sex of the individuals.
Materials and Methods:
Cranial computerized tomographic images (CT) of 200 normal subjects between the age groups of 18 and 80 years were observed in this study. The height, width, and depth of the maxillary sinuses were measured with a Philips Brilliance 64 CT. The statistical analysis for sex and age comparison for all the parameters was done.
Results:
The mean width, height, and depth of maxillary sinus in male on both right and left side were 27.8, 28.2, 39.9, 39.6, and 40.0, 39.7 mm but in females were 26.6, 26.7, 36.8, 37.1, and 36.6, 37.4 mm. The discriminative analysis showed that the accuracy of maxillary sinus measurements i.e. the ability of the maxillary sinus size to identify gender was 55% in females and 69.5% in males.
Conclusion:
This study on CT dimensions of maxillary sinuses may be beneficial for the ENT surgeons when planning for endoscopic sinus surgery and to support gender determination.
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879
Prevalence of diabetes and hypertension among a tribal population in Tamil Nadu
Shankar Radhakrishnan, Manivanan Ekambaram
January-June 2015, 3(1):66-71
DOI
:10.4103/2321-4848.154948
Background:
Diabetes and hypertension is affecting at an alarming rate in both rural and urban populations in India and very few studies had been carried out among the tribal population.
Objective:
To determine the prevalence rate of type 2 diabetes mellitus and hypertension and its associated risk factors among the tribal population in Salem District in Tamil Nadu.
Materials and Methods:
A total of about 525 tribal population above 40 years of age from various tribal places in Yercaud. All of them were screened for diabetes, by checking the random blood glucose levels and blood pressure, body mass index, dietary patterns, and physical activity levels were also recorded. Their knowledge about diabetes was also assessed by a set of 10 questions.
Results:
Among the study population, people who had RBS 200 was 28 (male = 11 and female = 17) and between 140 and 200 were 39 (male = 18 and female = 21) and people whose were in the prehypertensive stage was 185 (males 92 and female 93) and people in the stage 1 hypertension was 102 (male = 47 and female = 54) and in stage 2 hypertension was 64 (male = 33 and female = 29). The co-morbidity (diabetes and hypertension) was present in among 45 (male = 25 and female = 20). Among the study population only 1 was obese and 39 were overweight. Among the various risk factors smoking, alcohol and positive family history were found to have a statistical significant association for males whereas among females only the family history was found to have a statistically significant association for both diabetes and hypertension. The knowledge of diabetes among the study population was very poor. None of them were aware about the normal levels of blood sugar and the risk factors.
Conclusion:
The study documented that the prevalence of diabetes and hypertension is increasingly high in the tribal areas and their awareness levels were very poor.
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8
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SPECIAL ARTICLES
Novel herbal drug delivery system: An overview
Manoj Kumar Sarangi, Sasmita Padhi
January-June 2018, 6(1):171-179
DOI
:10.4103/amhs.amhs_88_17
The kind of novel herbal formulations such as polymeric nanoparticles, nanocapsules, liposomes, phytosomes, animations, microsphere, transfersomes, and ethosomes has been reported using proactive and plant selections. The novel formulations are described to have remarkable advantages over conventional formulations of plant actives and extracts which include enhancement of solubility, bioavailability, and protection from toxicity, enhancement of pharmacological activity, enhancement of stability, improved tissue macrophages distribution, sustained delivery, and protection from physical and chemical degradation. Phytosome is a patented technology developed by a leading maker of drugs and nutraceuticals, to incorporate standardized plant extracts or water-soluble phytoconstituents into phospholipids to produce lipid-compatible molecular complexes. The herbal drugs can be used in a more upright course with enhanced efficacy by incorporating them into modern dosage forms. This can be accomplished by designing novel drug delivery systems for herbal ingredients. The present review highlights the current condition of the development of novel herbal formulations and summarizes their type of active components, biological activity, and applications of novel formulations.
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MEDICAL HISTORY
The rise of physical therapy: A history in footsteps
Abdul Rahim Shaik, Arakkal Maniyat Shemjaz
July-December 2014, 2(2):257-260
DOI
:10.4103/2321-4848.144367
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ORIGINAL ARTICLES
Health-related quality of life among menopausal women
Thilagavathy Ganapathy, Samia Saud Al Furaikh
January-June 2018, 6(1):16-23
DOI
:10.4103/amhs.amhs_122_17
Background:
Menopausal symptoms impact physical, psychological, vasomotor, and sexual health-related quality of life (QOL) among women.
Objective:
This exploratory study aimed to assess the effects of menopausal symptoms on the QOL using Menopause-Specific QOL Questionnaire (MENQOL) among women in India.
Materials and Methods:
By purposive sampling,
n
= 140 women aged between 40 and 60 years were recruited, and the prevalence of menopausal symptoms and its relationship with physical, psychological, vasomotor, and sexual health-related QOL was assessed using MENQOL, at Arekare, Mico-Layout, Bangalore South, Karnataka, India.
Results:
The mean age at menopause was 49.59 + 3.09 years. Nearly 97.14% of women reported having experienced minimum five or more menopausal symptoms. The prevalence of symptoms in physical, vasomotor, psychological, and sexual domains was 74.56%, 60.7%, 44.68%, and 26.4%, respectively. An overall mean MENQOL score of physical (27.1 + 0.72), psychological (2.01 + 0.27), vasomotor (4.08 + 0.79), and sexual (3.89 + 0.59) health-related QOL among menopausal women showed poor QOL. Statistical significant differences were observed between the sociodemographic variables and the health-related QOL scores in all domains at
P
< 0.05.
Conclusion:
Menopausal women-centered integrated model of care would empower women to lead improved health-related QOL in the next one-third of postmenopausal life span development.
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REVIEW ARTICLES
Nasoalveolar molding treatment in presurgical infant orthopedics in cleft lip and cleft palate patients
N. Retnakumari, S. Divya, S. Meenakumari, P. S. Ajith
January-June 2014, 2(1):36-47
DOI
:10.4103/2321-4848.133804
The nasoalveolar molding (NAM) technique is a new approach to presurgical infant orthopedics that reduces the severity of the initial cleft alveolar and nasal deformity. This technique facilitates the primary surgical repair of the nose and lip to heal under minimal tension, thereby reducing scar formation and improving the esthetic result. NAM technique is the nonsurgical, passive method of bringing the gum and lip together by redirecting the forces of natural growth. NAM has proved to be an effective adjunctive therapy for reducing hard and soft tissue cleft deformity before surgery. This paper reviews the basic principles of NAM therapy, various types of appliances used in this therapy, protocol followed, and a critical evaluation of the advantages and disadvantages of this technique. Universally authors have agreed the positive outcome of NAM for better esthetics after cleft lip and palate (CLP) repair, but the long-term effects of this therapy are yet to be substantiated. Despite a relative paucity of high-level evidence, NAM appears to be a promising technique that deserves further research.
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7
21,361
2,317
Field cancerization: A review
M Aparna, Prashanth Shenai, Laxmikanth Chatra, KM Veena, Prasanna Kumar Rao, Rachana V Prabhu, KA Shahin
July-December 2013, 1(2):136-139
DOI
:10.4103/2321-4848.123026
Concept of field cancerization was first introduced over six decades ago in the setting of oral cancer. Later, field cancerization involving histologic and molecular changes of neoplasms and adjacent tissue was explained. Field cancerization involves the lateral spread of pre-malignant or malignant disease and contributes to the recurrence of head and neck tumors. The overall hypothesis underlying this work is that endothelial cells actively participate in tumor cell invasion by secreting chemokines and creating a chemotactic gradient for tumor cells. The article tries to explain the conflicting aspects of field cancerization in the setting of oral cancer.
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7
9,036
1,494
SPECIAL ARTICLES
Epilepsy and depression: An update
Marco Mula
January-June 2019, 7(1):104-111
DOI
:10.4103/amhs.amhs_54_19
Depression is one of the most frequent comorbidities in patients with epilepsy affecting 1 in 4 patients, and this is due to psychological and neurobiological reasons. This is a narrative review of the epidemiological, neurobiological, and clinical aspects of depression in epilepsy. References have been identified through Medline/PubMed searches till February 2019 using the terms “epilepsy” AND “depression”. Additional articles were identified from the author's own files and from chosen bibliographies. Epilepsy and depression have a complex bidirectional relationship suggesting shared neurobiological mechanisms and the possibility that depression is a premorbid symptom of some epilepsy syndromes. The phenomenology of depression can be different from that seen outside epilepsy, but epilepsy-specific screening instruments, such as the Neurological Disorders Depression Inventory for Epilepsy, are now available to be used in routine clinical practice. Sertraline and citalopram can be considered first-line treatment in moderate to severe depression while psychological treatments should always be offered to mild to moderate cases.
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6,545
612
ORIGINAL ARTICLES
The level of stress and coping mechanism adopted by I Year B.Sc. nursing students
C Viji Prasad, Amrutha Suresh, Dina K Thomas, MK Pritty, Sumaida Beebi, Vijapura Multazim
January-June 2013, 1(1):19-23
DOI
:10.4103/2321-4848.113554
Background:
Stress is a fact of life that every human deals with on a daily basis. In the transitional nature of student life in professional courses like nursing, initial period of course is stressful and it adversely affects the emotional, physical, social, and academic functions. Even though the perception and response to stress and way of coping differs individually, it may produce questionable behavioral patterns in student nurses during the course of their study like feeling of loneliness, nervousness, sleeplessness, and worrying. Thus, the student nurse faces a lot of challenges and problems at the time of I Year.
Objectives:
The present study aimed to determine the level of stress and coping mechanisms adopted by I Year B.Sc. nursing students.
Materials and Methods:
A total of 60 I Year B.Sc. nursing students were selected by using non-probability convenient sampling technique. The tools used for data collection were perceived stress scale, structured coping scale, and socio- demographic proforma.
Results:
The studies revealed that majority of students (95.1%) were in the age group of 17-19 years. The results showed that only one student (1.7%) has severe stress, 46.7% has moderate stress, and remaining 51.6% has mild stress, and majority of the students (100) had average coping. There was no significant correlation (-1.167) between stress and coping mechanism of I Year B.Sc. nursing students.
Conclusion:
Majority of students had mild stress and average coping. The nurse administrator should plan and organize educational program for nursing students, in order to prepare them to cope up with any stressful situations. Hence, the researcher emphasizes the need for more research to improve the knowledge and by applying the research finding for future.
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Effectiveness of structured teaching program on knowledge and practices of staff nurses on prevention of intravenous cannulae complications
Kanishka George, Bharti Muninarayanappa
July-December 2013, 1(2):115-119
DOI
:10.4103/2321-4848.123020
Infectious rates and peripheral intravenous cannulae-associated complications are very common in patients with intravenous therapy. This study was aimed to assess the incidence of intravenous cannulae complications among patients after 72 hours
in situ
and to examine the impact of structured teaching program on knowledge and practices of staff nurses. In this study, researcher used descriptive and quasi-experimental approach; a non-probability convenient sampling technique was adopted to select 80 staff nurses, each 40 in experimental and 40 in control group. 67.79% of patients developed peripheral intravenous cannulae-related complications with grade 1 (33.05%) and grade 2 (34.74%) complications. Result revealed that it was highly significant at 0.05 level (
t
= 9.978;
P
< 0.05) for knowledge and not significant (
t
= 0.974;
P
> 0.05) for practice. The post-test knowledge found to be highly significant at 0.05 level (
t
= 3.909;
P
< 0.05), whereas practice score was not significant (
t
= 0.426;
P
> 0.05). It could be inferred that there is no significant difference between the pre-test and post-test practice score of staff nurses who attended the structured teaching program regarding prevention of intravenous cannulae complications.
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10,472
899
SPECIAL ARTICLES
Problem-based learning in health professions education: An overview
Ajay Telang
July-December 2014, 2(2):243-246
DOI
:10.4103/2321-4848.144363
Problem-based learning (PBL) has been discussed and deliberated at various levels in health professions education in the last few decades. It has been accepted as a student-centered pedagogy that helps learners understand the core concepts, as well as helping them develop adult learning skills, communication skills, team working skills among other skills, which are considered as essential soft skills for future professional practice and employment. This article presents a description of the origin of PBL, the principles of learning that it is based on and a detailed description of the type of PBL process that can be used to introduce PBL. The research evidence in favor of PBL from the perspective of the faculty and the students has also been discussed with suggestions for future research based on literature.
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Online since 20 June, 2013