Kerala Medical Journal

Medical Education in India: Current State and Advancements

Kavitha Ravi — 2024-07-01

Medical education in India is undergoing significant transformation, driven by policy reforms, technological advancements, and a growing recognition of the need to align medical training with global standards. These changes are poised to address longstanding challenges while creating new opportunities for future healthcare professionals.

Pathways of Care in patients with Psychosis and factors that prolong the Duration of Untreated Psychosis (DUP) - A Cross-Sectional Study

Rachana S Menon — 2024-07-01

Background: With this study, the authors hope to identify the common care pathway taken by patients with psychosis and their caretakers along with the factors that lead to delay in treatment.
Aim: To study pathways of care and factors that delay help-seeking in patients in patients with psychosis
Method: A cross-sectional study was undertaken among patients with a clinical diagnosis of psychosis for a duration of 6 months. The study was conducted after obtaining ethical clearance from the Institutional Ethics Committee. Consent was taken from both the patient and a reliable informant. A semi structured Socio-demographic profile, Pathway to care assessment questionnaire and illness awareness and attitude questionnaire was administered. The results obtained were tabulated.
Result: It was found that none of the patients or their caretakers believed in faith healing or alternative medicine. All patients were fully compliant with their current treatment and believed it would help them get better. However, most patients and their families were still hesitant to disclose the nature of their illness to others fearing the stigma they would face.
Conclusion: Although there is an increasing decline in the use of faith healers and alternative medicine systems and rise in seeking treatment from mental health professionals, mental illness is still heavily stigmatized as evident from the percentage of patients who are divorced, unmarried, facing marital discord and unemployed. Efforts need to be made to de-stigmatize mental illness and ensure better treatment to patients with psychosis in order to provide them a healthy, happy and illness-free life.

Knowledge, Attitude and Practices of Menstrual Hygiene among High School Girls in Government Medical College Higher Secondary School, Thiruvananthapuram

Midhusha Mohan — 2024-07-01

Menstrual hygiene encompasses practices and knowledge essential for maintaining cleanliness and health during menstruation. A cross sectional study was done to appraise the understanding of menstrual hygiene among 103 adolescent girls (grades 8-12) at Government Medical College Higher Secondary School in Trivandrum, conducted between July and September 2023. Socio-demographic factors, knowledge acquisition, and comprehensive KAP (Knowledge, Attitude, Practice) scores pertinent to menstrual hygiene were captured using a semi structured questionnaire. This encompassed pre-menstrual awareness, comprehension of menstrual blood’s origin, identification of hormonal triggers, familiarity with diverse menstrual products, preferred sanitary provisions, ablution rituals, and disposal methodologies. While 62.1% demonstrated prior knowledge of menstruation, a mere 50.5% understood the genesis of menstrual blood. Despite a commendable understanding of hormonal triggers (86.4%), recognition of items like tampons (34%) and menstrual cups (74.8%) displayed notable variability. Sanitary pads were the predominant choice (95.15%), with minimal utilization of cloth pads (1.94%) or alternative materials (2.91%). Approximately 58.3% conscientiously adhered to using soap and water for ablution, while 66.99% opted for incineration as the disposal method for used items. The study revealed critical disparities in menstrual hygiene comprehension among adolescents, necessitating bespoke educational initiatives to elevate practices and instill heightened awareness.

Climate Change and Its Impact on Vector-Borne Diseases

Suma Krishnasastry — 2024-07-01

Climate change has become a global challenge especially in the context of health issues. Vector borne diseases are increasing in the tropical countries and this article aims to explore the relation between the climate change and vector borne diseases. Concerns have been raised on the contribution of human activities in climate change such as greenhouse gas emissions which traps son’s heat and increases temperature. Vector borne diseases like Malaria, dengue, Zika virus infection and chikungunya are on the increase. The effect of increasing temperature in the lifecycle and behavior of the vectors, alteration in precipitation patterns and change in ecological landscapes are some of the reasons. The socioeconomic implication of these changes is huge. It is important to develop mitigation and adaptation strategies to prevent escalation of vector borne diseases.

Food Allergy: How Labelling the Food you Serve can Save Lives

Austin Joju Mangaly — 2024-07-01

Food allergy and associated anaphylaxis is an issue that plagues an unfortunate section of the world population and at times can prove fatal. Modern immunology has devised techniques for prevention, early diagnosis and to an extent, cure through desensitisation for food allergies. It is as important for clinicians to be aware of these developments to educate their patients, as it is for them to know how to manage a case of food-induced anaphylaxis in the emergency room. Labelling food items served at gatherings, with details of the ingredients and allergen information is a simple yet highly effective strategy to prevent fortuitous anaphylactic episodes and threats to life.

A Visual Cue based Antibiotic Prescriber Software Application system to minimize the Prescription of Watch and Reserve Group Antibiotics in Hospitals

Aravind Reghukumar — 2024-07-01

AWaRe classification was introduced by World Health Organization [WHO] in 2017 for minimizing the further emergence and spread of antimicrobial resistance. AWaRe classifies antibiotics into three stewardship groups with traffic signal like colour codes: Access, Watch and Reserve to emphasize the importance of optimal use and potential for antimicrobial resistance. A visual cue based antibiotic prescriber software application system based on AWaRe colour codes will help in enhancing awareness, encourage judicious antibiotic use, and to mitigate the knowledge- behavior gap in antibiotic prescribing. This software will help to minimize the prescription of Watch and Reserve category antibiotics in hospitals and thereby promote the use of Access category antibiotics. Through this the project aims to contribute to the attainment of the WHO target of having 60% of total antibiotic prescriptions to be from the Access category.

What is a Plant Predominant Eating Pattern?

V C Manoj — 2024-07-01

The article outlines various plant-predominant diets that focus on consuming plant-based foods and their impact on health. It categorizes diets into vegan, vegetarian, flexitarian, Mediterranean, low-fat, very low-fat, and raw food diets, each with different levels of animal product inclusion.
The vegan diet excludes all animal products, while the vegetarian diet may include dairy and eggs. The flexitarian diet allows occasional meat consumption, and the Mediterranean diet includes fish, seafood, and moderate dairy and poultry. Low-fat and very low-fat diets prioritize whole, minimally processed foods and exclude unhealthy fats and sugars. The raw food diet focuses on uncooked plant foods.
It is important to note that not all vegan diets are high-quality, as they can include unhealthy processed foods. In contrast, a whole foods plant-based (WFPB) diet is nutrient-rich and associated with reduced chronic disease risks.
Specific diets for medical conditions are DASH diet for blood pressure, the Portfolio diet for cholesterol, the MIND diet for Alzheimer’s and cognitive health, and the low-fat plant-based diet for type 2 diabetes management. The Fasting Mimicking Diet (FMD) and the historical Rice diet are also mentioned.
Their maybe concerns about protein intake in plant-based diets, but it is possible to meet protein needs through diverse sources. Vegetarians and vegans might need slightly more protein due to lower digestibility of plant proteins and that older adults could benefit from higher protein intake for muscle and bone health. However, excessive animal protein consumption is linked to health risks and reduced life expectancy.

Novel Biomarkers for Prediction of Cardiovascular Morbidity

J Devika — 2024-07-01

Cardiovascular diseases are still one of the most common causes of deaths in the world .The changing demographics of fatal cardiovascular events is a significant indicator to consider new approaches in risk prediction and risk stratification.This article aims to address a few probable bio markers which may help determine the probability of an underlying cardiovascular condition much before the onset of acute symptoms.

Antiphospholipid Antibodies in Multiple Sclerosis: The Chicken or Egg Paradox

Anagha Rajiv — 2024-07-01

We present the case of an adult gentleman with features of both multiple sclerosis and antiphospholipid antibody (aPL) syndrome. Whether this antibody is involved in the primary disease pathogenesis or it only signifies the dysregulation of humoral immune response is being debated and concluded through this case report.

Bronchial Carcinoid – A Case Report

Thasni A Sherief — 2024-07-01

Bronchial carcinoids are rare tumours of the lung. These are diagnosed on bronchoscopy, biopsy and histopathology. The timely identification of these tumours can facilitate recurrence free treatment by surgical excision. This case report describes the clinical presentation, diagnosis and management of a patient with bronchial carcinoid

A Rare Type of Atypical Fracture Femur without Bisphosphonate Therapy: A Case Report

Ashwin Suresh — 2024-07-01

Atypical femoral fractures are stress fractures occurring in femoral shaft usually associated with prolonged use of antiresorptive therapy. Various reports have shown that long term use of rheumatoid arthritis medications may also impair mineralization of bone. Here we are discussing a case of atypical fracture femur seen in person who was not on bisphosphonate therapy.

Good Sleep, Good Health

C John Panicker — 2024-07-01

Good sleep is not a luxury but an essential requirement for physical, mental and emotional health. Prioritising quality sleep is essential for overall health and well-being. From cognitive function to emotional regulation, the benefits of sufficient sleep are undeniable. Insufficient sleep adversely affects the functioning of various vital systems in our body. Practising sleep hygiene is essential for ensuring adequate and quality sleep thus resulting in maintaining good health.

Diabetes Mellitus: Tasting to Testing and Treatment – Part 1

J Sajikumar — 2024-07-04

Diabetes mellitus (DM) is a metabolic disease, involving inappropriately elevated blood glucose levels. Globally, 1 in 11 adults has DM. Diabetes occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces.