Amrita Journal of Medicine

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Migrants and forcibly displaced people are one of the worst affected sections in the COVID-19 pandemic. More or less every country has felt it to be a challenging task to look after the health of migrants in a similar way as they are supposed to do so for their own citizens. Migrants need to be given special attention when it comes to testing and treatment because they could be both victims and potential sources of this SARS COV-2 virus. In this article, some important issues related to migrants’ health in this pandemic have been briefly addressed.

Hemoptysis is an important and alarming symptom with various etiologies. A thorough evaluation should be done by the clinician to identify the underlying pathology and site of bleeding, so that the appropriate treatment can be planned. In our review article, we describe the various etiologies of hemoptysis and define the approach to hemoptysis for the clinician and the relevant investigations. We performed literature searches in PubMed for keywords “Hemoptysis and Approach and Diagnosis” using Medical Subject Heading terms. The etiology of hemoptysis may sometimes be missed by an incomplete initial diagnosis; hence, the diagnostic work up should be exhaustive. Optimal diagnostic workup remains largely unclear. Through our review, we have described the causes of hemoptysis, provided an essential diagnostic pathway according to the accuracy of the investigations, and tried to fill the gaps regarding the subject.

Competency-based medical education focusses on performance and outcome. The work-based assessment methods assess the highest level of Miller’s pyramid of assessment (Does). The portfolio is one of the methods needs to be implemented in medical education. Learning and assessment are two vital components of training of any medical resident. Portfolio-based learning not only keeps the resident updated but also increases his/her professional growth exponentially. The portfolio is not a new concept but its use in medical residency is yet to be practised universally.

Background and Objectives: The ongoing coronavirus pandemic was first identified in Wuhan, Hubei, China on December 2019. India reported its first case on January 30, 2020 in Kerala. As COVID-19 is mostly a droplet infection, it necessitates the use of masks, gloves, and sanitizers for containing its spread. This study aims to understand the potential adverse effects of constant use of masks, gloves, and sanitizers among healthcare workers (HCWs). Materials and Methods: This is a cross-sectional study conducted among 165 HCWs from a single tertiary healthcare center in Kerala using a validated questionnaire. Data were analyzed using Microsoft Excel and SPSS version 20. Results: Among 165 participants, the most common adverse effects due to mask usage were dermatological in nature (57%). With regard to sanitizers, majority experienced dryness of hands (53.3%). Gloves were well tolerated with 62% of the participants reporting no adverse effects. Conclusion: Prolonged use of mask, sanitizer, and gloves has caused adverse effects in majority of HCWs surveyed. As the pandemic still stands as a crisis, it is necessary to identify solutions to manage these adverse effects for the betterment of the health of our HCWs.

Background: Dysphagia in Parkinsonism is often reported, and diagnosed, late. This can be a contributor to morbidity and mortality. Hence, a screening tool is essential as part of routine workup of these patients. The gold standard diagnostic modality for dysphagia is Videofluoroscopic Swallowing Study (VFSS). However, being an interventional imaging procedure, it cannot be made routine for every case. Aim: To study swallowing problems in patients with Parkinsonism using a screening questionnaire and to objectively observe the findings at VFSS in these patients. Materials and Methods: Fifteen patients (nine males and six females) attending the Parkinsonism clinic over a period of 1 year, and meeting the inclusion criteria, were included in the study. After standard neurological evaluation, they were administered our screening tool, the Amrita Dysphagia Screening Questionnaire (ADSQ). Next, they underwent VFSS. The scores and findings from these were documented, and the results were tabulated. Results: The average Hoehn and Yahr scale and ADSQ scores were 0.488 and 0.799, respectively. Mean age was 68.9 years. In VFSS, all the patients showed features of oropharyngeal swallowing disorders characteristic of Parkinsonism. These included features of bradykinesia such as tongue pumping, smaller tongue movements and piecemeal deglutition in the oral preparatory stage of swallowing, and reduced pharyngeal constriction, premature spillage, vallecular and pyriform sinuses residue, reduced hyoid movement, prolonged transit time, delayed laryngeal closure, aspiration/penetration, and repetitive or multiple swallow in the pharyngeal stage of swallowing. Conclusion: The present study has documented the objective findings of swallowing disorders, especially of the oral phase, in patients with Parkinsonism. This, along with our screening tool, must be considered essential in the management protocol for this debilitating neurological condition.

Bacterial parotitis is most commonly due to oral or dental focus in non-immunocompromised patients. Ultrasonography and guided aspiration are the diagnostic tools, and appropriate antibiotics and supportive medications are the treatment modality. A diagnosis of tubercular parotitis is extremely rare and can be a cause for concern with regard to delayed diagnosis and the possibility of complications. The present case report is about such a case: a young lady with no comorbidities presenting with initial diagnosis of parotid abscess. Evolution and management of the case, with relevant literature, are discussed.

Online since 18^th June 2019