The Covid-19 effect on medical students’ perceptions of their profession: A mixed methods study from South India

Covid-19 has devastated human lives and stretched the limits of the medical profession and health systems. Using the mixed methods of online survey and online focus group discussions, we assessed how medical students and interns of two medical colleges in South India viewed the profession they had chosen. Of the 900 participants, 571(63.4%) had a positive perception of the medical profession, 77(8.6%) a negative perception and 252(28%) were undecided. The year of study in medical school was significantly associated with their perception of the medical profession, with interns more likely to have a negative perception (p<0.001). An overwhelming 823(91.4%) participants remained confident of their career choice, but a higher proportion of interns were less confident or regretful about their choice of profession compared to first to fourth year students (p<0.001). Most participants experienced moral distress; they acknowledged a duty to care but were troubled by personal risk, inadequate protection, and limited resources. Gaps were identified in medical and ethics training particularly regarding uncertainties and coping with deficiencies of the health system as encountered in the pandemic. The essential role played by doctors with its required competence, care and ethics cannot be assumed or expected without investment in the making of the future doctor through more socially embedded medical education imparting the skills of understanding the public, responding to them and being the advocate for their equitable and optimal care. An ethics of responsiveness emerges as important for healthcare, also for medical education in preparation for future health crises.

Current Controversies in the Management of Patent Ductus Arteriosus in Preterm Infants.

Objective: Patent ductus arteriosus is very commonly seen in very low birth weight (VLBW) infants, affecting about one-third. The present review tries to identify the group of VLBW infants who need active intervention in day-to-day practice and to determine the mode of intervention, based on current published literatures. Methods: We searched the Cochrane library, MEDLINE, EMBASE and CINAHL databases, and reference that of identified trials. Results and Conclusions: Preterm infants with a birth weight of <800g are at risk of significant morbidity and mortality from PDA; it would be reasonable to treat them when symptomatic or if requiring positive pressure ventilator support. Those weighing >800g are unlikely to need treatment unless they are ventilator-dependent or show evidence of congestive heart failure.

Carbapenem resistance among Escherichia coli and Klebsiella pneumoniae in a tertiary care hospital in south India.

Carbapenem resistance among clinical isolates of Enterobacteriaceae, especially Escherichia coli and Klebsiella pneumoniae, is largely conferred by metallo-β-lactamase (MBL). Fifty-one non repetitive isolates of carbapenem-resistant (Meropenem and Imipenem) E. coli and K. pneumoniae were studied to determine the molecular mechanism for resistance. Presence of blaNDM and blaVIM was determined by polymerase chain reaction (PCR) and DNA sequencing. blaNDM was detected from majority of carbapenem-resistant K. pneumoniae (75%) and E. coli (66.6%). Timely detection and appropriate and aggressive infection control measures are required to control the spread of these bacteria in healthcare settings.

Recent trends in drug delivery systems: liposomal drug delivery system--preparation and characterisation.

Liposomes are potential drug carriers for variety of drugs, therapeutic proteins and diagnostic agents. Drug entrapment ability of liposomes makes it more useful in targetting of drugs to specific site within the body. Major components of liposomes include lipids, water, drugs, electrolytes, antioxidants, preservatives and viscosity inducing agents. Considering the widespread use of liposomes in drug therapy and problem of physico-chemical instabilities of liposomes, this article aims at giving an insight into various methods of preparation of different types of liposomes like, unilamellar and multilamellar vesicles, consideration of some critical aspects of manufacturing processes and the characterization of liposomal drug delivery system in reference to vesicle size distribution, determination of residual organic phase in the phospholipid bilayer system, per cent drug encapsulation and identification.

Chondroid syringoma-scalp. A case report.

A case of chondroid syringoma of scalp is reported. The case is of particular interest because of repeated recurrence with bone and dural infiltration.