Study of the post tuberculosis lung diseases and the impact of various patient and disease related factors on its occurrence

Background: More than fifty percent of the cured cases of pulmonary tuberculosis develop some form of chronic pulmonary dysfunction. It can present with varying degrees of lung damage, ranging from minimum functional abnormalities to severe forms of dysfunction that can be an important cause of death. Objective of the study to identify the various Post Tuberculosis Lung Diseases (PTBLDs) and to study impact of the patient and disease related factors on its occurrence.Methods: Cross-sectional, observational study was conducted in 134 adult, post tuberculosis patients, aged between 18-65 years, who have completed at least one year after the end of anti-tubercular treatment. All symptomatic post TB lung disease patients coming to the pulmonology out-patient clinic at the Apollo Institute of Medical sciences and Research were included in the study.Results: Majority were more than 50 years (35.3%) and males (59.4%). Majority were from urban areas (70.7%), low social class (72.2%), and unskilled workers (56.4%). Most common symptom was cough in 74.4% cases. Majority of the cases had symptoms from one week to one month i.e. 47.4%. Only eight cases were found out to be very prompt in reporting their symptoms. 39 cases had some or the other co-morbidity. Current chest X-ray status was normal in only three cases. Mean FEV1 was 1.38 which increased to 1.52; mean FVC was 1.23 which increased to 1.58; mean FEV1/FVC was 67.37 which increased to 72.76 after giving the bronchodilator. 78(58.6%) cases had obstructive and 27(20.3%) had restrictive lung disease. In 30 cases the disease was reversible. Majority of the cases were of pulmonary fibrosis followed by bronchiectasis.Conclusion: Further studies are needed to develop approaches for the prevention, care and treatment of patients with post TBLD.

The Impact Of Positive Role Models On Student's Intent To Choose Respective Medical Specialties.

Background: Role models play a very vital role in clinical training in medical schools. Medical students gain professional expertise by being exposed to experienced and knowledgeable preceptors. There have been very few studies on the association between role models in medical education and the choice of the clinical field, the medical students intends to choose later on. Literature on the specific attributes the faculty should possess to become role models are also sparse. Methodology: An observational cross sectional study was conducted in AIMSR involving 100 interns. A well-structured pre-validated questionnaire pertaining to the impact of role models on medical students was distributed to the interns at the initiation of their internship. The student’s responses for the questionnaire were tabulated and analyzed to see, if any association exists between the role models and the clinical field, the students intend to choose by calculating the P-value using Chi-square test in SPSS-24 Version. An attempt was done to explore what are the specific attributes of role models chosen by our students. Results: There was 74% correlation between role models in a particular speciality and the career choice of students when the students chose role models from the clinical departments only. Developing rapport with students was the most important attribute that was important for students to choose their role models followed by creating enthusiasm in students, treating students with respect, effectively communicating with patients and their family and demonstrating clinical signs to the students. Conclusion: There exists a significant correlation between speciality to which the role models belong and career choice of students. Developing rapport with the students is very important attribute, the students look for in their role models.