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   Table of Contents - Current issue
Coverpage
January-March 2022
Volume 18 | Issue 1
Page Nos. 1-36

Online since Sunday, May 8, 2022

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REVIEW ARTICLE  

Ensuring Problem-Based Learning for Medical Students and Looking Forward to Developing Competencies p. 1
Manish Taywade, Kumbha Gopi, Debkumar Pal, Bimal Kumar Sahoo
DOI:10.4103/AMJM.AMJM_55_21  
Problem-based learning (PBL) is one of the most efficient teaching methods leading to critical thinking and problem-solving abilities or competencies. Medical education has multiple opportunities to use PBL in its curriculum. The educator and students have a bidirectional understanding, which encourages the activation of prior knowledge skills, facilitates the comprehension of new information, and improves learners’ critical thinking. Students have the scope of exploring the topic of interest in a real-life scenario. PBL is an innovative instructional method in which problem forms learning basics, and it allows the students to solve complex issues efficiently. Training of medical students involves both classroom teaching and practical applications. PBL is gaining popularity due to significant suggestions such as students’ learning and encouraging motivation to learn with an interdisciplinary integration of knowledge. PBL is more effective than lecture-based learning in the academic performance of medical students in producing better quality medical students.
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ORIGINAL ARTICLES Top

Degree of Hearing Threshold in Patients with Type 2 Diabetes Mellitus Highly accessed article p. 4
Emmanuel Salvador Hernandez Alvarado, Laura Melissa Román Marín, Carlos Alberto Cuellar Ramos, Patricia Vieyra Reyes, Hugo Mendieta Zerón, Virgilio Eduardo Trujillo Condes
DOI:10.4103/AMJM.AMJM_54_21  
Background: Type 2 diabetes mellitus (T2DM) leads to multiple chronic complications in the body including sensory functions. Aim: The aim of this study was to determine the hearing threshold in middle-aged patients with T2DM and categorize it according to the presence or absence of hearing loss. Materials and Methods: A prospective, cross-sectional study was performed with 40 patients with T2DM (mean age 58 ± 8.6 years and mean time of T2DM evolution 11.9 ± 8.2 years) and 40 nondiabetic subjects (mean age of 52.4 ± 10.9 years). Pure tone audiometry was performed with a Grason-Stadler GSI 18 screening audiometer, 11 frequencies (0.125–8 kHz) were evaluated and classified as low, medium, and high. Hearing loss was defined as a hearing threshold >20 decibels (dB) and was classified as: mild: 21–40 dB, moderate: 41–70 dB, severe: 71–90 dB, and profound: > 90 dB. Results: Compared to the control group, diabetic patients presented a significant increase in the hearing threshold at medium (P < 0.05) and high (P < 0.0001) audiometric frequencies. When hearing loss was present, it was almost entirely mild (>80%) in the control group, whereas diabetic patients presented moderate, severe, and even profound levels of hearing loss. A linear correlation was found between the diagnosis time of T2DM and the degree of hearing loss at high frequencies (P = 0.04) as well as at medium frequencies (P = 0.01). Conclusions: T2DM affects hearing from the early stages of the disease; routine evaluation of hearing function should be considered in this population.
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Utilization of Neutrophils-to-Lymphocytic Ratio as a Marker for Post-operative Pain in Patients Undergoing Harmonic Cholecystectomy: A Single-center Study p. 10
Ahmed Tarabay, Ahmed Hafez Mousa, Hanin Ahmed Radwan, Islam Khaled
DOI:10.4103/AMJM.AMJM_51_21  
Objectives: Our study aimed to investigate the pre-operative neutrophils-lymphocytes ratio (NLR) in patients who underwent cholecystectomy and to identify whether it discriminates between chances of developing pain or not and at what interval. Materials and Methods: A cross-sectional study was conducted in a single center in Saudi Arabia over a period of 2 months. Analysis was conducted using SPSS 22nd edition; numeric variables were presented in mean ± standard deviation and compared using the Mann–Whitney U-test after normality testing. Results: The study included 69 patients diagnosed with acute cholecystitis and underwent cholecystectomy. The minimum identified NLR in our study was 0.3 and the maximum identified variable was 15.0. Highest sensitivity and specificity were found to be 93.8% and 24.5% after 36 h of performing the procedure, respectively. Conclusion: NLR utilization as a pain marker post-operatively has promising outcomes which will highly impact the reduction of disease burden on patients.
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Experiences of Menstruation with Factors Influencing Menstrual Hygiene Practices Among Adolescent Girls Attending Outpatient Department of Secondary Care Hospital Setting: A Cross-sectional Study p. 20
Mansi Pal, Shyama Devi, Manish Taywade
DOI:10.4103/AMJM.AMJM_2_22  
Background: Menstruation is a physiological process as it brings changes in a young woman’s life. In this process, menarche is the most important phase in menstruation. It is the onset of first menstruation in girls. In today’s time also, menstruation is confused by different perceptions, myths, and misconceptions, which later affect their menstrual hygiene practices. Materials and Methods: The mixed method approach is adopted for the study. A qualitative approach using an in-depth interview was adopted for exploring the experiences of adolescent girls, and a quantitative approach was used for assessing factors influencing menstrual hygiene practices. Results: Adolescent girls had various experiences regarding their menarche. Seventy-four percent of girls had average menstrual hygiene practices. Several influencing factors were found and after applying binary logistic analysis four risk factors were found, which are caste, problems faced by girls during menses, frequency of changing pads, and method of disposal. Conclusion: The present study shows that girls had various experiences at the time of their menarche. They are having average menstrual hygiene practices, and there are various factors found which influence menstrual hygiene practices. Though there are several modules to maintain menstrual hygiene, still many adolescent girls lack resources such as a supply of clean water, availability of toilets, and use of sanitary pads.
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Impact of the COVID-19 Pandemic: The Perceptions of Students about Change in Medical Education p. 26
Divya Goel, I P S Grover
DOI:10.4103/AMJM.AMJM_11_22  
Objectives: The COVID-19 pandemic has disrupted teaching in a variety of institutions, especially in medical schools. Online learning became the main method of teaching during the COVID pandemic. After 12 weeks of online teaching and online learning, a study was conducted to know about the student’s perception regarding online teaching during the COVID-19 pandemic. Materials and Methods: A study was conducted by distributing an online questionnaire to medical students. At the end of the survey, summarized data from a google spreadsheet were analyzed. Descriptive statistics and t-test analysis were used for data analysis. Results: Overall, 460 students answered the questionnaire. According to the respondents’ answers, the main advantages of online learning were the ability to stay safely at home (68.56%), meet academic requirements (26.65%), and the opportunity to beat the boredom of lockdown (4.79%). The majority of respondents chose a lack of interactions with teachers (59.52%). Overall, 51.74% respondents did not want online learning to continue after the COVID pandemic. Conclusions: Online learning is a powerful tool for teaching medical students. However, for its successful implementation, a well-thought-out plan and a more active approach is required.
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CASE REPORT Top

Pseudoaneurysm of an Internal Mammary Artery Due to Tuberculosis p. 29
Jayabal Pandiaraja, Arumugam Shalini
DOI:10.4103/AMJM.AMJM_48_21  
Tuberculosis is the most common pulmonary infection in developing countries. Vascular complications are known to occur as a part of disease progression. Aneurysm associated with internal mammary artery can be true aneurysm or pseudoaneurysm. Pseudoaneurysm of the internal mammary artery can be due to invasive procedures or as a part of infective etiology. Tuberculosis destroys the wall of blood vessels leading to the formation of pseudoaneurysm. Early identification and intervention of pseudoaneurysm will avoid complications of hemorrhage, hemothorax, and hemorrhagic shock. We present a case of tuberculous empyema that causes pseudoaneurysm of an internal mammary artery managed with coil embolization along with antituberculous treatment.
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SHORT COMMUNICATIONS Top

Assessment of Self-directed Learning Sessions: Approaches, Challenges, and Strategies to Overcome the Challenges p. 32
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/AMJM.AMJM_6_22  
Considering the changing dynamics in the field of medicine and the expectations of the community from the healthcare professionals, it is an indispensable need that all medical professionals strive to become better. As a matter of fact, being adult learners, medical students have to devise their own strategy to attain the expected competencies, and this essentially requires the inclusion of self-directed learning (SDL). SDL plays an important role in the making of a lifelong learner and thus lays down the seed for a successful medical practitioner. The need of the hour is to plan assessments for topics allocated to SDL, which will ensure that medical students start taking these topics seriously. These planned assessments can be carried out either as self-assessment or peer assessment or by the involvement of teachers. In conclusion, SDL is an important aspect of undergraduate training, and its importance or benefits derived from it can be significantly enhanced by supplementing the same with assessments. Even though the assessment of SDL is a challenging task, but with proper planning and teamwork, we can benefit the students and thereby aid them in the process to attain the desired competencies.
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Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2: Necessity to Strengthen Public Health and Social Measures p. 35
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/AMJM.AMJM_50_21  
The coronavirus disease-2019 (COVID-19) pandemic continues to be one of the global public health emergencies and interrupts the routine lives of humans. Omicron has been identified as the most recent variant of concern by the World Health Organization, and it has been detected first from the samples reported in South Africa. This variant has been found to have genetic changes that can influence the virus attributes (such as transmissibility, the severity of resulting illness, or limitations in terms of diagnosis––the absence of S gene, making it difficult to establish a diagnosis or reduced potency of existing therapeutic drugs) and has the potential to account for significant community transmission. In conclusion, the detection of the omicron variant of COVID-19 definitely calls for attention from international agencies, program managers, public health authorities, and the community. As we continue to get an in-depth understanding of the new variant in the coming days, the need of the hour is to strictly adhere to the public health and social measures at our end.
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