ABSTRACT
Background and Objectives: Pathology is a broad subject consisting of various branches, such as hematology, clinical pathology, biochemistry, histopathology, cytology, blood banking, and others. All the subspecialties are difficult to cover in depth in a 3-year MD Pathology course and curriculum. Hence, it was decided to investigate whether the MD Pathology curriculum is able to meet the challenges of today's laboratory medicine practice. So, a survey was conducted among newly qualified pathologists who have passed their exam within last 5 years. Purpose was to know their views about MD Pathology curriculum with special emphasis on challenges they face during their day-to-day practice. Materials and Methods: Study is designed as cross-sectional survey conducted via web-based Google forms questionnaire. Study population is pathologists qualified within last 5 years. A convenience sample of eligible pathologists was taken by sending a web-based Google form to various pathology groups on social media apps. Data were collected in the Google spreadsheet software and various responses were summarized as percentages, graphs, and pie-charts as necessary. Chi square test was used to find the significance of difference in responses from government, private, and deemed university respondents. Results: Different numbers of responses were received to different survey questions. Out of 187 respondents, 65 (34.8%) worked in a hospital-based laboratory, 61 (32.6%) did jobs in a private laboratory, 49 (26.2%) worked in a medical college, and 37 (19.8%) worked in their own private laboratories. Out of 193 respondents, 158 (81.9%) were working in hematology, 149 (77.2%) in clinical pathology, 139 (72%) in cytopathology, 118 (61.7%) in histopathology, whereas 103 (53.4%) worked in clinical biochemistry, and least number of respondents, i.e., 38 (19.7%) were working in blood bank. Almost all the respondents had overlapping work in hematology and other areas. The level of confidence rated by the respondents was best in hematology, followed by clinical pathology; it was least for clinical biochemistry and blood bank. Out of 192 respondents, 64.1% (123) felt that the curriculum does not equip them for lab management and administration, 21.9% (42) felt that the curriculum somewhat equipped them; whereas only 14.1% (27) felt that curriculum equips them for this task. There were 191 responses to the question regarding satisfaction with MD Pathology curriculum; out of which, 51.8% (99) were not satisfied, 24.6% (47) said they may be satisfied, whereas 23.6% (45) were satisfied with the curriculum. There was no significant difference in responses from government, private, and deemed university respondents. Conclusions: The graduating MD Pathology students expressed confidence in reporting routine cases of hematology, clinical pathology, routine cytology, and histopathology. However, there is difficulty in clinical biochemistry, blood banking, and reporting of malignancies. The laboratory management and administration, communication skills, and quality assurance are also other areas of weakness. MD Pathology program needs more focus on these weaknesses, so that newly qualified graduate would feel confident in day-to-day laboratory working.
ABSTRACT
Purpose: To determine the magnitude and direction of association of anxiety and depression and the quality of life (QoL) in persons with glaucoma. Methods: This prospective cross?sectional study in conducted in a tertiary eye center in north Kerala included glaucoma patients and normal subjects aged 40–80 years. The Patient Health Questionnaire?9 (PHQ?9), the Generalized Anxiety Disorder?7 (GAD?7), Glaucoma Quality of Life (GQOL), and glaucoma evaluation were performed for all participants. One?way analysis of variance was used for statistical analysis. Results: The study included 148 subjects with glaucoma and 150 subjects without glaucoma. The prevalence of depression (35.81%) and anxiety (25.0%) was significantly higher in glaucoma patients. In a multivariate regression model, PHQ?9 (adjusted OR: 2.39, 95% CI: 1.31–4.38, P < 0.001), GAD?7 (adjusted OR: 2.06, 95% CI: 1.01–4.19, P = 0.01) and GQOL (coefficient: 6.92, 95% CI: 4.52–9.31, P = < 0.001) was significantly associated with glaucoma. The GAD?7 score was significantly higher (P = 0.02) in PACG compared to POAG in moderate and severe anxiety. ADL scores (one?way ANOVA, P = 0.001) and GQOL scores (one?way ANOVA, P < 0.001) were significantly associated with vision impairment and blindness. Conclusion: Depression and anxiety are common in glaucoma patients, indicating the need for screening protocols using PHQ and GAD scales to identify persons at risk. The lack of ophthalmic risk factors associated with depression and anxiety emphasizes the importance of psychological evaluation and combined management with a psychiatrist in glaucoma management.
ABSTRACT
Background: Menorrhagia accounts for 12% of all gynaecology consultations and is one of the most common causes of iron deficiency anaemia in females after nutritional anaemia. Objectives: To evaluate the efficacy and side effects of ormeloxifene in cases of dysfunctional uterine bleeding. Material and Methods: 30 women aged 28-46 years who attended the outpatient gynaecology department in a tertiary care hospital with complaint of heavy menstrual flow were recruited for the study. Two pretreatment baseline cycles were compared to the treatment cycles of ormeloxifene. The main outcomes measured were menstrual blood, blood haemoglobin levels and endometrial thickness in proliferative phase as studied by TVS. Data thus collected was compared and analysed statistically. Results: Total number of bleeding days per year decreased by 76%. Total no. of pads soiled per cycle decreased by 76.3%. All the patients reported disappearance of clots, 66.66% within 1 month of the treatment only. Dysmenorrhoea was relieved in 62.5% patients. Mean increase in Hb was 0.42g%. Conclusion: Ormeloxifene is very effective in improving all the parameters of blood loss in DUB including the no. of days of bleeding, no. of pads soiled and the passage of clots. Ormeloxifene has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule. In the peri-menopausal age group, drug is protective against breast malignancy and osteoporosis. Ormeloxifene has the potential to be an effective treatment for DUB and should always be considered amongst the treatment options.
ABSTRACT
A 5-year-old girl was admitted with pallor, hypopigmented sparse hair, tongue ulcers, atrophic nail changes, hypoplastic anemia and bilateral exudative retinopathy. A diagnosis of Revesz syndrome was made. She had the additional features of retinal detachment and retinitis pigmentosa, which are hitherto unreported in this syndrome.