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   Table of Contents - Current issue
Coverpage
September-December 2018
Volume 4 | Issue 3
Page Nos. 245-337

Online since Monday, December 24, 2018

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EDITORIAL  

What's New in Academic Medicine? Advocating for global health program funding in academic medicine p. 245
Diane L Gorgas, Pamela L Potter
DOI:10.4103/IJAM.IJAM_56_18  
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EXPERT COMMENTARY Top

Leading from Your Upper Brain™ p. 249
Michael E Frisina, Robert W Frisina
DOI:10.4103/IJAM.IJAM_60_18  
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REVIEW ARTICLES Top

Medical applications of stereolithography: An overview p. 252
Anish Kaza, Julia Rembalsky, Nicholas Roma, Vikas Yellapu, William G Delong, Stanislaw P Stawicki
DOI:10.4103/IJAM.IJAM_54_18  
Stereolithography or three-dimensional printing (3DP) is a fast-growing field, with increasing number of health-care applications. As an industry, stereolithography is expected to grow from an estimated $700 million to nearly $9 billion in revenue over the next few years, mainly due to continued advancements and practical implementations of the technology. More established applications of 3DP in medicine involve the creation of wearable assist devices, prosthetics, and orthotics. Research is ongoing in the area of incorporating biologic (including genetic) implementations of 3DP technology, with the long-term goal of three-dimensional printing of organs and tissues that can be subsequently implanted into human body. Given that applications of 3DP in health-care have only recently begun to proliferate, there continues to be paucity of literature in this important and rapidly evolving area of research. In the current review, we sought to present a comprehensive and most current high-level overview of 3DP, with the goal of catalyzing better general understanding and promoting research in 3DP for biomedical applications. The following core competencies are addressed in this article: Medical knowledge, Systems-Based Practice.
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Hypernatremia: A systems-based approach p. 266
Joseph G Noto, Ravindra Bollu, Tudor Sturzoiu, Sudip Nanda
DOI:10.4103/IJAM.IJAM_8_18  
Hypernatremia is a commonly encountered disorder in hospitalized patients in which the plasma sodium concentration exceeds 145 mM. The clinical approach to hypernatremia is often challenging for clinicians, as the underlying pathophysiology is complex and serious complications can result from its improper management. As such, the purpose of this manuscript is to provide the reader with a systematic clinical approach to the diagnosis and management of patients with hypernatremia. The following core competencies are addressed in this article: Patient care, Medical knowledge.
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ORIGINAL ARTICLES Top

Non-operative management of blunt hepatic injury: Early return to function, chemical prophylaxis, and elucidation of Grade III injuries p. 271
Meghan E Wooster, M Chance Spalding, James Andrew Betz, Sandi Sellers, Matthew L Moorman, M Shay O'Mara
DOI:10.4103/IJAM.IJAM_93_17  
Background: Selective non-operative management of blunt hepatic trauma has shown decreased mortality and iatrogenic injury. Evidence-based recommendations are difficult to obtain regarding management of Grade III hepatic injuries and safe timing to implement return to function measures (enteral intake, chemical deep vein thrombosis [DVT] prophylaxis, and ambulation). Materials and Methods: This is a prospective, observational study of 130 trauma patients with blunt hepatic injuries over 2 years. A guideline was utilized to emphasize early hepatobiliary iminodiacetic acid scan and return to function measures at 24 h after injury. Patients were treated non-operatively with endoscopic retrograde cholangiopancreatography, percutaneous drainage, or embolization per evidence-based guidelines. Results: Fifty-seven patients suffered Grade III–V blunt liver injury. The biliary leak rate was higher for Grade IV and V liver injuries than Grade III (48%, 43%, and 12%, respectively) compared to lower grade injuries (0%). There was no significant difference in complications from initiation of chemical DVT prophylaxis, ambulation, or early enteral intake as a function of grade of hepatic injury. The average time to progression of treatment was 24 h and independent of the grade of liver injury. High-grade liver injuries were associated with lower age, increased injury severity score, and increased Intensive Care Unit length of stay. Conclusions: Trauma providers should consider Grade III liver injuries as low-grade injuries and treat accordingly. However, Grade IV and V injuries fail non-operative management more often than other grade injuries. Early enteral nutrition, chemical DVT prophylaxis, and ambulation are safe regardless of the grade of hepatic injury. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, Systems-based practice.
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Effectiveness of music therapy on academic performance of nursing students p. 278
Arumugam Indira, Phanishree V Pydimarry, Kantha Katari, Rajeswari Hemanathan, Ranabir Pal, Amrita Ghosh, Prashant Bhandarkar, Priti Patil, Amit Agrawal
DOI:10.4103/IJAM.IJAM_32_18  
Background: It has been shown that music has effect on intellectual functions, behavioral aspects, and emotional aspects of students. The present study explores the role of music on these aspects of nursing students. The purpose of this study is to observe the effect of music listening on academic performance. Materials and Methods: Data were collected using a questionnaire. Sociodemographic data, study habits, home-related aspects, teacher-related aspects, and academic performance rating scale was used to analyze the academic performance of the students. Instrumental flute and violin music called Raag Shivaranjani and Raag Mohana were administered to the experimental group using a comfortable head set; it took 10 min for each sample. Music therapy was withheld from the control group. Posttest was conducted on 30th day in both intervention and control group with the same tool to assess the effectiveness of music therapy. Results: Of the 191 participants, intervention arm in the music therapy group (91 nursing students) and in the control group (100 nursing students), the positive findings obtained were that listening to music during studying had positive effects on the concentration of students and improved the academic performance. In the posttest academic performance rating to assess the effectiveness of music therapy, “estimate the percentage of written Nursing Foundation (care plan and case study) work completed (regardless of accuracy) relative to classmates” and “estimate the accuracy completed written nursing foundation (care plan and case study) work (i.e., percent correct of work done)” there were statistically significant changes in academic performances on exposure to music therapy. Conclusions: The current study suggests that a sub-group of students can get benefitted when the music is used as an intervention to improve academic performance. The following core competencies are addressed in this article: Medical knowledge, Practice-based learning and improvement, Interpersonal and communication skills.
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Surgical residents and palliative care, hospice care, advance care planning, and end-of-life ethics: An analysis of baseline knowledge and educational session to improve competence p. 284
Mark Dalvin, Julie Aultman, Michael S Firstenberg
DOI:10.4103/IJAM.IJAM_22_18  
Introduction: The American Board of Surgery expects competence in interdisciplinary palliative care, and dealing with advancing chronic conditions and end-of-life scenarios are part of Accreditation Council for Graduate Medical Education general surgery milestones. Despite established standards, surgical trainees receive limited amounts of formal palliative care training, if any. Objective: The study purpose was to evaluate baseline knowledge and test effectiveness of an educational session for surgical residents focused on palliative care, hospice care, advance care planning (ACP), and related topics. Methods: The study was completed at Northeast Ohio Medical University with participation from general surgery residents, students, and faculty at Northside Regional Medical Center in Youngstown, Ohio. Participation involved a pretest, lecture, and posttest surrounding palliative and hospice care, ACP, and related topics to teach and assess baseline knowledge and usefulness of an educational session based on test comparison. Mean group scores for pre/post-tests were calculated. A paired one-tailed t-test was used to assess effective change in mean scores. Results: Twenty participants completed the session. The mean pretest score for the group was 60%. The mean posttest score for the group was 75%. Results show that, after the 30-min presentation, there was statistically significant improvement between means (P = 0.00002). Conclusions: Palliative care, hospice care, and ACP are not utilized to potential due to poor residency education as indicated by low mean pretest score. Statistically significant improvement between tests indicates that education focused on these topics can remedy the knowledge gap and presumably improve patient care involving these topics. The following core competencies are addressed in this article: Practice-based learning and improvement, Interpersonal and communication skills, Professionalism.
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Evidence-based medicine workshop for teaching faculty of a medical college: Kirkpatrick level 1 evaluation p. 289
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/IJAM.IJAM_20_18  
Background: Evidence-based medicine (EBM) is a holistic approach of integrating research findings with the existing knowledge in modern medicine. The objective of the present study was to evaluate the reaction level (Kirkpatrick level 1) of the faculty participants who attended a workshop on EBM so that necessary steps can be taken to improve the organization of similar workshops in future. Materials and Methods: It was a cross-sectional descriptive study, conducted among faculty from different specialties who had attended a 1-day workshop on EBM. A feedback form was used to assess the response of the participants regarding the different aspects of the workshop. Statistical analysis was done using SPSS version 23. Frequency distributions were calculated for all the variables. Results: The 1-day workshop on EBM was attended by 24 faculty members and it consisted of 5 sessions. All the 24 (100%) participants liked the overall organization of the workshop, with 6 faculty (25%) appreciating the interactive and informative nature of sessions and group activities. Further, 5 (20.8%) faculty members found the workshop to be useful as they were of the opinion that the knowledge gained in the session would aid in the delivery of better patient care, and for better teaching of undergraduate and postgraduate students. Conclusion: Kirkpatrick level 1 evaluation was done for the EBM workshop, and it was found that all the participants liked the overall organization and content of the workshop, but also expressed their opinion for more exposure on critical appraisal of research articles and searching Cochrane's database. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and Improvement.
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CASE REPORTS Top

Kaposi's sarcoma of the colon presenting with diarrhea and weight loss p. 295
Rodrigo Duarte-Chavez, Lauren E Stone, Leah N Grandi, Ayaz Matin, Kimberly J Chaput, Santo Longo, Berhanu M Geme
DOI:10.4103/IJAM.IJAM_4_18  
Kaposi's sarcoma (KS) is a rare tumor caused by human herpesvirus-8. The lesions present as reddish to purple slow growing macules that become nodular, typically affecting the extremities and sometimes associated to mucosal, visceral or lymph node involvement. KS is very prevalent in immunosuppressed patients and Sub-Saharan Africa. Gastrointestinal (GI) involvement is more common in the upper GI tract and usually presents as bleeding. We present a case of a 60-year-old male presenting with Kaposi's sarcoma of the colon, with diarrhea and weight loss as the clinical manifestation of the disease. The following core competencies are addressed in this article: Patient care, Medical knowledge.
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ZNF469 mutation in a case of Ehlers–Danlos syndrome presenting with glomerulonephritis p. 299
Smita Nath, Pinkesh Parmar, Sana Shadab, Sandeep Garg, Suresh Kumar, Vinod Scaria, Sridhar Shivasubu
DOI:10.4103/IJAM.IJAM_11_18  
Ehlers Danlos syndrome is the term applied to a group of rare genetic disorders charactersised by joint hypermobility, skin fragility and hyperextensibility. However the syndrome includes patients with rare distinctive features like severe muscle hypotonia, marfanoid habitus, kyphoscoliosis, osteopenia, keratoconus and eye globe rupture. We present a case of Ehlers-Danlos Syndrome Type VI, with ZNF 469 mutation affecting two siblings born out of consanguineous marriage. The following core competencies are addressed in this article: Medical knowledge, Patient care, Systems-based practice.
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LETTERS TO EDITOR Top

Simulation-based medical education and effective staffing ratios p. 303
Yixing Chen, Scott M Pappada, Thomas J Papadimos
DOI:10.4103/IJAM.IJAM_1_18  
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Medical professionalism in India: Present and future p. 306
Shrivastava RamBihariLal Saurabh, Shrivastava Saurabh Prateek
DOI:10.4103/IJAM.IJAM_30_18  
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Intimate partner violence: An abominable factor affecting brace compliance p. 308
Ganesh Singh Dharmshaktu
DOI:10.4103/IJAM.IJAM_24_18  
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CONFERENCE ABSTRACTS AND REPORTS Top

The Third Annual Academic International Medicine World Congress (AIM 2018) “Translating Evidence into Global Innovation” in Brooklyn, New York, July 27–29, 2018: Event Highlights and Scientific Forum Abstracts p. 310
Bonnie Arquilla, Christina Bloem, Ricardo Izurieta, Donald Jeanmonod, Rebecca K Jeanmonod, Sudip Nanda, Pia Daniel, Thomas J Papadimos, Miguel Reina Ortiz, Manish Garg, Michael S Firstenberg, Sagar C Galwankar, Annelies L DeWulf, Gregory L Peck, Ziad C Sifri, Stanislaw P Stawicki
DOI:10.4103/IJAM.IJAM_57_18  
The Academic International Medicine World Congress (the AIM World Congress) is the official annual meeting of the American College of Academic International Medicine, a United States organization dedicated specifically to connecting academic physicians from diverse areas of expertise toward the common goals of sustainable global medical outreach and multinational clinical research and education. The organization's main focus is to promote academic international medicine and to establish a platform for individuals, academic institutions, and a broad range of multisectoral organizations to converge and work collectively to create a foundation for efficient, effective, and sustainable resource sharing. World-renowned experts and speakers from the AIM community attended and participated in the Third Annual Congress (AIM 2018) held in Brooklyn, New York, from July 27 to July 29, 2018. In addition to an increase in the number of high-profile faculty members, medical students, and other trainees, as well as the doubling our attendance compared with the AIM Congress 2017, this year's Annual Meeting also incorporated the Cochrane Diagnostic Test Accuracy Review Course. The conference theme, “Translating Evidence into Global Innovation” showcased efforts of the academic international medical community to utilize and create objective data to achieve global impact. Finally, the Congress featured the Second Annual Scientific Forum as a platform for exchanging scientific knowledge among scholars. This report presents an overview of this major academic event, including the listing of podium and poster presentations from the 2018 Scientific Forum. The following core competencies are addressed in this article: Practice-based learning and improvement, Systems-based practice, Interpersonal and communication skills, Professionalism.
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