Sane and safe: Forced social distancing to prevent human-to-human transmission of COVID-19

@#The current outbreak of COVID-19, originating from the city of Wuhan in China and ultimately involving over 200 countries, is now a global concern. Evidence indicates that COVID-19 spread to humans from wild animals, causing severe respiratory tract infections in humans; the typical symptoms of COVID include cough, high-grade fever, sore throat, and difficulty in breathing. The infection spreads from human to human via droplets. Therefore, social or physical distancing can reduce spread within communities. Asymptomatic spread can also occur during family gatherings or in the workplace; thus, we must enforce physical distancing as much as possible to reduce the spread of cases.

Spectrum of mucocutaneous manifestations of diabetes mellitus in Jharkhand

Objective: To study the prevalence and the pattern of mucocutaneous manifestations among diabetic patients to aid in better management of diabetic skin diseases

Methods: Three hundred consecutive patients with the diagnosis of diabetes mellitus [DM] and seeking treatment for skin lesions in the OPD of Department of Dermatology in Rajendra Institute of Medical Sciences, Ranchi were included in the study

Results: Diabetic patients accounted for 7.2 percent of Dermatology OPD attendance with a male preponderance [M:F=1.4:1]. The common skin disorders for which patients sought treatment were: superficial fungal infections [24 percent], acrochordons [17.7 percent], xerosis [13.7 percent] and bacterial infections [7.4 percent]

Conclusion: Skin problems are quite common among diabetic population. Most of the dermatoses were infectious in nature. The early detection of mucocutaneous manifestations in DM is of utmost importance to be able to avoid and manage the complications and prevent disability

Palisaded encapsulated neuroma: a unique presentation

Palisaded encapsulatee neuroma [PEN] is a genign intraneural neuroma presenting as a solitary, sessile, immobile, asymptomatic, skin-coloured papule or nodule, commonly affecting the butterfly area of the face of a middle-aged person. It is not associated with neurofibromatosis or multiple endocrine neoplasia. We hereby report a unique case presenting with a firm, nodular growth over the posteromedial aspect of right knee which progressively increased in size over one year. On the basis of histopathologic findings, diagnosis of palisaded encapsulated neuroma was made. It is imperative to diagnose it histopathologically, because it is more commonly middiagnosed clinically with schwannoma and neurofibroma

Comparison of student's self-assessment to examiners assessment in a formative observed structured clinical examination: a pilot study

To compare students' self-assessment with assessment by examiners in a formative observed structured clinical examination [OSCE] and comparison between cumulative score and global rating scale for students and faculty evaluation. This cross sectional study was carried out on 6[th] year medical students of Oman Medical College, Family Medicine rotation in a formative OSCE. A self-assessment questionnaire was completed by 15, Year 6 students immediately after the OSCE. Statistical analysis was done with SPSS 16.0 for Windows. Regression analysis was used to correlate self reported rating and actual performance in each station. A p value of < 0.05 was considered significant. Correlation between cumulative score and global rating scale for students and faculty evaluation was calculated by Pearson correlation. Students has done appropriate self-assessment on dyspepsia history while the other two stations have shown some discrepancies in self-assessment and examiners assessment. Self-assessment is comparable to examiner evaluation. Examiners assessment has shown consistent and positive correlation between cumulative scores and global rating scores while students had failed to show this consistency

Fibromyalgia syndrome: an overview of pathophysiology, diagnosis and management

Fibromyalgia Syndrome [FMS] is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. It is also characterized by restless sleep, tiredness, fatigue, anxiety, depression, and disturbances in bowel functions. The etiology of fibromyalgia remains unknown, but recent advances and discoveries have helped to unravel some of the mysteries of this disease. Research highlights some of the biochemical, metabolic, and immunoregulatory abnormalities associated with fibromyalgia. Management of FMS at the present time is very difficult as it has multiple etiological factors and psychological predispositions; however, a patient centered approach is essential to handle this problem

Frequency of abnormal pap smear and assessment of risk factors for cervical cancer in an out-patient clinic

To estimate the frequency of abnormal Pap smear and assessment of risk factors for cervical cancer in an out-patient clinic of a tertiary care hospital. All married female patients attending the preventive health check up [family medicine] clinics, The Aga Khan University Hospital. Karachi from December 2004 to April 2005 for general checkups and had Pap smear after informed consent, were included. Data were collected through a structured questionnaire administered to all participants and double entered in EPIDATA and analyzed in SPSS. Frequencies of all variables were generated. Means with standard deviations and ranges were also calculated for quantitative variables. A total of 103 patients were enrolled. The mean age was 45.8 +/- 10.7 years. Half of the study population were menstruating at the time of interview, Mean age at marriage was 21.4 +/- 4.57 years. Mean age at first pregnancy was 22.6 +/- 4.4 years. A minority of husbands [2.9%] were uncircumcised. About one third [30.8%] of patients had at least four full term deliveries while the mean number of deliveries were 3.3 +/- 2.0 years. More than one third [36.9%] were practicing contraception, with 5% using oral contraceptive pills and the rest using barrier methods. About one third of the women complained about vaginal discharge with foul smell, dysuria and dyspareunia in most patients. About two-third [63.1%] had at least one Pap smear in the past. None had any dysplasia or cancer. Reports of Pap smear findings showed that 16.5% patients had atrophic vaginitis, 37.9% had infective bacillary background diagnosed on histopathology and the rest were reported normal. Time most frequent abnormality found in Pap smear study was infective bacillary back ground. None of the patients had any pre-cancerous or active cervical cancer. The study was limited by small sample size and choice of Pap smear by the elite class population with self referral for general health checkup

Attributes of an effective clinical teacher: a survey on students' and teachers' perceptions

To identify the attributes of effective clinical teacher, using a self-filled survey questionnaire, that students and faculty value most, and to compare the opinion of student and faculty regarding the same. Cross-sectional study. The Aga Khan University Hospital [AKUH], Karachi from October 2006 to January 2007. Clinical faculty at AKUH and students in clinical years were included in this survey after taking their written informed consent. Data were collected through a structured questionnaire administered to all participants. Responses were compared. A total of 119 students in clinical years [3, 4 and 5] and 89 faculties involved in clinical teaching responded to the questionnaire. The most important attributes in faculty's and students' perspective were knowledge, interest in teaching and clinical competency. In students and faculty perspective, the fourth and fifth attributes were good communication skills and being non-judgmental. Students in clinical years and clinical teachers valued knowledge, interest in teaching and clinical competency as the most important attributes for an effective clinical teacher. There were various areas of agreement and disagreement between faculty and students about attributes of effective clinical teacher

Metabolic syndrome: frequency and gender differences at an out - patient clinic

To determine the frequency of metabolic syndrome among patients attending an out-patient clinic of a teaching hospital and to compare the clinical features regarding metabolic syndrome among males and females. Cross-sectional study. Aga Khan University Hospital [AKUH], Executive and Family Medicine Clinics, from December 2004 to April 2005. All adults, above 25 years, attending the clinics for an executive check-up and giving informed consent were included in the study. Data was collected through a structured questionnaire administered to those eligible to participate. Metabolic syndrome was defined according to ATP-III guidelines. There were 250 participants in this study. Mean age of study participants was 48.94 [SD10.62] years, while approximately two-thirds, 157 [62.8%], were male. Metabolic syndrome [those who had 3 or more risk factors] was present in 35.2% of adults. Fasting blood sugar level was raised in 36.4% of study participants while significant number of participants [78.8%] had a Body Mass Index [BMI] 25 [p = 0.02]. Frequency of metabolic syndrome was significantly high in this study with preponderance of males and prevalence similar to that observed in developed countries. Majority of patients had obesity and high fasting blood sugar levels. Males demonstrated higher levels of triglycerides and low levels of High-density lipoprotein [HDL] compared to females while blood pressure reading was observed to be the same in both males and females