Effectiveness and Implications of a Structured Hands-on Training on OSCE for Nursing faculties: A pilot project by Trained Nurse's Association of India

Nursing is one of the professions which require knowledge along with clinical competence to provide high quality nursing care. Objective Structured Clinical Examination (OSCE) and Objective Strucured Practical Examination (OSPE) methods of evaluation have emerged as an alternative to traditional evaluation methods for the skills assessment. This study was planned to train nursing faculties on OSCE and evaluate its effectiveness. The primary objective of the for nursing faculties on knowledge regarding OSCE. A one group pretest-posttest design with a quantitative research approach was used. Convenient sampling method was used include 27 faculties from all the available colleges of Nursing in NCT of Delhi. A structured 15-item questionnaire with multiple choice questions, each comprising four responses with one correct response was used to evaluate the knowledge of the participants regarding OSCE. The twoday training programme comprised the theory sessions and demonstration of OSCE stations ties. The study suggests that there is a need to develop a structured training programme and conduct training for faculties across the country to bring in uniformity in implementation of OSCE method of evaluation in colleges.

Impact of Midwife-led Supportive Educational Intervention on Perinatal Outcome among Fearful Primipara Mothers

The aim of the study was to develop and assess the effect of supportive-educational intervention on perinatal outcome among primipara mothers with a fear of childbirth. This randomised controlled trial was conducted on 205 primipara mothers with a fear of childbirth attending a Gynae OPD. At 24-28 weeks of pregnancy primipara mothers were screened for fear of childbirth WDEQ-A and then randomly allocated to experimental and control group. Within one week of delivery perinatal outcome was assessed with help of self-made checklist. After the interventions, there were signi cant differences between groups on post-intervention scores for term of delivery and newborn birth weight at p'lt;0.001. Based on the results of the study it can be concluded that supportive educational intervention was effective in primipara mothers for positive birth outcome.

A Prospective Study to Assess the Knowledge Regarding Maternal and Child Health Services available among Antenatal Women Visiting Antenatal OPD, Government Medical College and Hospital in Chandigarh.

The objective of the study was to assess the knowledge regarding maternal & child health services available to antenatal mothers and to fi nd out association between knowledge score and selected socio demographic variables. A prospective, observational research design was used. Convenient sampling technique was used to select 120 subjects visiting antenatal OPD, Government Medical College & Hospital (GMCH), Chandigarh. Data was obtained from study subjects by proformas developed by the researchers consisting of Part A- having socio-demographic data and Part B- covering knowledge regarding maternal & child health services available. Approval was taken from research and ethical committee of the institution as well as from incharge of academics GMCH. Data analysis was done by calculating mean, standard deviation, percentage and correlation coeffi cient by using descriptive and inferential statistics; p-value below 0.05 was considered statistically signifi cance. Majority of the antenatal women had average knowledge regarding maternal & child health services available. There was no association between knowledge score and demographic variables. The fi ndings show that out of total subjects 24.2 percent had good knowledge, 62.5 percent had average knowledge and 13.3 percent had poor knowledge regarding maternal & child health services.

Comparison of Morphometry of Foramen Magnum and Posterior Cranial Fossa in Dry Human Skull

Bougie is an important adjunct in the anaesthesiologist armoury for a difficult airway1. Physical damage to bougie leading to airway trauma is rare but can be catastrophic. We report a case of an anticipated difficult extubation, where the bougie, used to extubate over the tube broke and migrated into the trachea indicating the need of a protocol for routine inspection of bougie which should be strictly adhered to

Very-late Onset Mania Episode: Case Report and Review of Cases Over 75 Years of Age

Introduction: Bipolar I disorder typically characterized bycycles of depression and mania. Onset after the age of 75 yearsis very rare and the reported incidence of mania is 2/100000,which most often occur due to secondary organic aetiology.Here we are presenting a review and an interesting case oflate-onset first episode mania while evaluating and excludingall other secondary causes of mania.Case Report: 79-year-old male presented with 2 weeks’duration of illness and symptoms was suggestive of a manicepisode. The patient was thoroughly assessed with laboratoryinvestigations and non-contrast computerised tomography(NCCT) brain to find any secondary causes of mania butnothing was significant. Finally, as per tenth revision of theInternational Statistical Classification of Diseases (ICD-10)diagnosis of first episode Mania without psychotic symptoms(F30.1) was made. He was started on Valproate which wasgradually increased up to 750 mg/day and olanzapine 5mg.After 6 weeks, the YMRS score decreased from 32 to 8 and heachieved his premorbid functioning level.Conclusion: This case highlights that primary psychiatryillness can occur at any age but in the geriatric populationbefore finalizing the diagnosis all other secondary causesshould be ruled out. There is a high need for systematicresearch in this area to formulate effective managementguidelines in the geriatric population.

A Suspected Case of MEHMO – Rare X-linked Mitochondrial Disorder

Introduction: MEHMO (Mental retardation, epilepticseizures, hypogonadism and hypogenitalism, microcephalyand obesity) is a rare and complex X-linked disorder whichcharacterized by profound intellectual disability, epilepticseizures, hypogonadism and hypogenitalism, microcephalyand obesity. By genetic haplotype and linkage analysis,disease locus has been assigned to Xp21.1 - Xp22.13.Case report: The patient was born to non-consanguineousparents near the term of delivery and clinically was verysimilar to the syndromal description of MEHMO. Familyhistory of deaths of 2 maternal uncles below the age of 2 yearssuggests X- linked inheritance.Conclusion: The findings of index case warrant cliniciansto be more vigilant while assessing such cases and calls forthorough clinical examination, family history, detailed labwork up and molecular genetics whenever possible to supportand contribute towards literature in futur

Foramen Magnum: Morphometry, Possible Variation In The Shape And Its Clinical Implication

Introduction: Foramen magnum is midline opening in the occipital bone in the floor of posterior cranial fossa. Morphometryof cranium also helps in establishing the origin of various neurological and skeletal pathologies and also designing varioussurgical procedures and approaches.Methods: We conducted a study on 50 dry skull bones in the Department of Anatomy, Government Medical College and Hospital,Chandigarh. The foramen magnum was analyzed for its shape, anteroposterior (AP) diameter, width/transverse diameter (TD),area, perimeter, and FM index. All the measurements were taken with Vernier caliper and were statistically evaluated.Results: The common shape observed was hexagonal in 45% of cases. The mean of AP and TD was found to be 34.44 mmand 30.46 mm. AP diameter was more than TD. FM index and perimeter were found to be 98.91 mm and 88.44. However, areaof foramen magnum was observed to be 745.727 mm2.

A Case Report Of A Variant Head Of Gastrocnemius

The Gastrocnemius muscle is a fusiform, two-headed, two-joint muscle. The two heads of origin are lateral andmedial head taking origin from medial and lateral condyles of femur. In between the two heads tibial nervepasses. Its other end forms a common tendon with the soleus muscle; this tendon is known as the tendocalcaneusor Achilles tendon which get inserted to posterior surface of calcaneum. The case was reported during routinedissection for undergraduate M.B.B.S. students in Government Medical College and Hospital, Chandigarh. Thesubject was 70-year-old male cadaver of North Indian origin. The accessory head was observed during thedissection of popliteal fossa. The Gastrocnemius muscle was bulky. The inferolateral and inferomedial boundaryof the popliteal fossa were made by medial and lateral head of gastrocnemius. In addition to the normal medialand lateral head an accessory head of gastrocnemius was observed. The accessory head had bipennatearrangement of the muscle fibers. in the left lower limb were observed. All the heads were innervated by branchesfrom tibial nerve. It is possible that this variant muscle could have a compressive effect on the tibial nerve andpopliteal vessels, and the awareness of this may prevent its misinterpretation as a pathological structure byradiologists and surgeons

Intramuscular Lipoma at Shoulder: A Rare Case Report.

Lipomas are the most common type of soft tissue tumors. Intramuscular lipoma is a rare type of deep-seated lipomas, which arise within the skeletal muscle fibres. It can arise in the background of history of trauma, obesity, chronic irritation, metabolic disorders, etc. Lipomas are usually benign, but sometimes clinically and grossly, they simulate malignancy. Intramuscular lipomas also need separation from muscular dystrophies. Histopathology is must to differentiate. Prognosis of intramuscular lipoma is very good and marginal excision is the treatment of choice. We report a case of 32 years old female, who presented with a painless swelling shoulder since six months. She had history of trauma eight years back. Grossly, the received mass was yellow-tan coloured, well circumscribed swelling of soft tissue along with muscle. Histopathologically, features are consistent with intramuscular lipoma. We report this case because of its rarity.

Diversity of Globins in Myxobacteria.

Globins are heme proteins that are capable of reversible oxygen binding. All globins can be classified into three families: the M (myoglobin-like), S (sensor) and T (truncated) globins. M and S globins exhibit the canonical 3/3 α-helical fold, and T globins are characterized by a 2/2 α-helical fold. Globins in the genomes of myxobacteria have not been characterized till date. Myxobacteria have very large genomes relative to other bacteria and have a unique life cycle that involves the aggregation of cells into fruiting bodies under starvation conditions. The diversity of globin like sequences in 14 sequenced genomes of myxobacteria is presented in this review. In myxobacterial globins some unusual domain architectures are identified that have not been characterized in bacteria so far; these are: i) a unique chimeric group I 2/2 HbN in the genome of Corallococcus coralloides DSM 2259; ii) M globin chimera harboring a central and a C-terminal globin domain in Sorangium cellulosum ‘so ce 56’ and Plesiocystis pacifica SIR-1 respectively; iii) two tandem globin domains on the same M globin polypeptide in the genomes of Sorangium cellulosum.

A Comparison of Clinical Features among Patients Suffering from Depression in HIV Positive and HIV Negative Cases.

Background: Depression is common in patients with HIV/AIDS, and its identification and treatment are critically important in disease management. HIV positive individuals have a estimated prevalence rate of depression about 22% - 45% compared with 15% of general population. This study compared the clinical features of major depressive disorder between HIV-Positive and HIV-negative patients with a view to intervention strategies. Method: A comparative, descriptive, cross-sectional study was carried out on 50 HIV-Positive depressed patients and 50 HIV-negative depressed patients in ICTC centre of Civil hospital, Gurdaspur. They were compared along the parameters of clinical features of depression and physical examination. Results: Compared to HIV-Negative patients, HIV positive patients were more likely to have a medical illness and taking medication before onset of depression, symptomatically compared to HIV-Negative patients. HIV-Positive patients had poorer sleep, felt more easily tired, more appetite changes, more suicidal ideation. Conclusion: These findings show that the clinical and associated features of depression differ between HIV-Positive and HIV-Negative patients, thus requiring different management approaches and further studies related to HIV-related depression.