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BACKGROUND: The corona virus disease (COVID-19) pandemic has caused widespread effect on the lives of health care professionals. The postgraduate medical students, who are the major pillars of medical institutions had to bear multitude of setbacks due to the pandemic involving academic, research and well-being issues. MATERIALS AND METHODS: This was a cross sectional feedback based online survey done in the month of October 2021 to study the effect of COVID-19 pandemic induced changes in the postgraduate medical education; amongst 78 students pursuing MD/MS degree in all departments of a tertiary medical institute in Himalayan foothills of North India. The questionnaire consisted of ten questions; each of which needed to be answered on a five point Likert scale ranging from strongly disagree to strongly agree. Results were assessed for the most common answers of each question (represented by mode) and association between various components of the questionnaire analyzed by Spearman's rho correlation coefficient. RESULTS: The internal consistency of the questionnaire as tested by Cronbach's Alpha (0.82) was good. Most number or respondents were from surgical branches (n = 31, 39.74%). There was a generalized agreement towards preference of resumption of onsite education (75.64%), the lack of variety of cases causing hampering of thesis work (88.46%) and increased mental stress during the pandemic (58.9%). While more time for self-study was seen as the only consensual positive aspect of online teaching (64%), most students opined that technical glitches are a major roadblock in online education (80.76%). Significant positive correlation was seen between disciplinary ease and punctuality in online teaching (R = 0.543, P < 0.001), lack of interaction and its effect on learning and mental health (R = 0.471; P < 0.001) and the lack of diversity in cases and difficulties in dissertation work (R = 0.351; P < 0.05). Negative correlation was observed between the satisfaction from overall learning through online teaching and the desire of resumption of offline classes (R = -0.491; P < 0.001). CONCLUSION: COVID-19 pandemic and its effects on medical education are long lasting. A comprehensive approach is required to rebuild the medical education curriculum, inculcating both traditional and newer virtual methods of education. A consistent support in academics and overall growth needs to be provided to medical postgraduate residents who have been the first line fighters in face of the massive disaster compromising their basic needs and education.
RESUMO
Introduction: Spontaneous pneumomediastinum is an uncommon complication of Corona Virus Disease (COVID)-19 presenting mostly in moderate to severe cases. Materials and Methods: This is a retrospective observational imaging and hospital data-based study done on 15 confirmed patients of COVID-19 who underwent high resolution computed tomography (HRCT) thorax at the Department of Radio-Diagnosis of a tertiary medical center in the Himalayan foothills. The clinico-radiological profile of the study group was assessed and it was aimed at finding the association of pneumomediastinum with the severity of lung changes. Results: A strong association of pneumomediastinum was observed with severe lung changes on HRCT thorax (n = 13, 87%, P < 0.00001). Dyspnea was the most common presenting factor. The mortality rate is high in mechanically intubated patients of pneumomediastinum with COVID-19 (75%). Conclusion: Pneumomediastinum is a complication of a severe COVID-19 disease spectrum. Along with severe lung parenchymal disease, systemic inflammation, systemic steroid therapy, comorbid state, and mechanical intubation, it is a part of the pool of poor prognostic factors. HRCT is essential for making a quick and comprehensive diagnosis, thereby, guiding the clinician for further management.
