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   Table of Contents - Current issue
Coverpage
January-June 2019
Volume 7 | Issue 1
Page Nos. 1-31

Online since Thursday, June 20, 2019

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EDITORIAL  

Rational use of antibiotics in clinical practice: Pharmacological considerations p. 1
Sagun V Desai
DOI:10.4103/JIHS.JIHS_17_19  
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REVIEW ARTICLE Top

Recognizing and plugging the gaps toward holistic pediatric dental care p. 3
Adrija Buch, Swara Shah, Pratik B Kariya, Vinay Mulchandani
DOI:10.4103/JIHS.JIHS_6_19  
Pediatric dentistry is the most versatile branch of dentistry that caters to the dental needs of infants to young adults. Pediatric dentists believe in delivering comprehensive oral health care and aim at providing welfare to the child as a whole. Various researches are been carried about the treatment modalities and material science, but literature lacks details about the role of a pediatric dentist in the fields such as dental neglect, child abuse, and sports dentistry. Pediatric dentists play a major role in recognizing, managing, and treating children of child abuse. In the similar way, they are also making an effort to spread awareness to eradicate dental neglect. Dental trauma during sports can be also be prevented with appliances such as custom-made mouthguards provided by the pediatric dentists. With the increase in competition and expectations from children, development of bruxism due to stress has increased significantly; hence, it is a major concern for paedodontists to treat such patients before they develop severe symptoms. This review article intends to highlight upon the role of a pediatric dentist in such scenarios.
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ORIGINAL ARTICLES Top

Effect of systemic doxycycline on scaling and root planing in chronic periodontitis p. 8
Dhwani Vyas, Neeraj Chandrahas Deshpande, Deepak Dave
DOI:10.4103/JIHS.JIHS_4_18  
Background: Periodontitis is a multifactorial chronic inflammatory disease. It occurs due to inflammation and tooth-supporting tissues destruction by subgingival microbiota. Anti-infective therapy has been accepted as the cornerstone of periodontal treatment. Aim: The aim of the study was to evaluate the efficacy of doxycycline as adjunct to scaling and root planing in treatment of chronic periodontitis. Materials and Methods: A total of 52 participants having moderate to severe chronic periodontitis were included and divided into 2 groups: Group A (Test group-SRP+Doxycycline) and Group B (Control group-SRP alone). Plaque Index (PI), Gingival Index (GI), Probing Depth (PD) and Clinical Attachment Level (CAL) were assessed at baseline and 3 months interval. Result: Significant differences were seen from baseline to 3 months in both test and control groups in terms of reduction in PI, GI, PD and gain in CAL (P<0.001). Inter-group analysis showed significant differences between the two groups after 3 months, with GI, PD and CAL with P-value <0.001. Conclusion: At the end of 3 months, Doxycycline showed better results after mechanical therapy in the treatment of patients with chronic periodontitis because it has an anticollagenase effect that can inhibit tissue destruction and aid bone regeneration.
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Comparative evaluation of structured clinical case examination with traditional long-case examination for clinical competence assessment p. 13
Hetal Pandya
DOI:10.4103/JIHS.JIHS_2_19  
Background: The clinical examinations are of key importance in competency assessment for medical education. However, in traditional long-case examination (TLCE), the product of history taking and physical examination is assessed, and the process is not observed. We suggest a structured clinical case examination (SCCE) with the aim to develop the best possible evaluation method for clinical competencies of undergraduate medical students. Methodology: A new assessment method SCCE based on principles of (1) direct observation, (2) objectivity, and (3) structured format was developed. This cross-sectional study was done during the internal ward ending examination of 3rd-year clinical batch. Students' views about TLCE were taken. The examination with SCCE and TLCE methods was taken by four subject faculties for two subgroups A and B, respectively. Feedback was taken from students and examiners in preformed questionnaire. Faculties' views regarding feasibility, objectivity, process, content, impact on assessment, and learning were noted through focus group discussion. Results: On quantitative analysis of results of both methods, SCCE has found to have a better categorization of the students in competent, average competent, and noncompetent groups, while TLCE group has shown clustering of students (up to 66%) in the average group. Almost all students strongly agreed that SCCE method is better than traditional method on almost all parameters. All examiners found this new method feasible, doable, and more objective. Conclusions: The proposed SCCE method fulfills almost all characteristics for ideal clinical competency assessment method. It can be easily implemented as an assessment method in clinical subjects.
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Appropriate use of antimicrobial agents in urinary tract infections: Perception of physicians and resident doctors p. 19
Jitendra D Lakhani, Sucheta J Lakhani, Shah Meera, Panchasara Sanket, Jain Sandeep
DOI:10.4103/JIHS.JIHS_18_19  
Appropriate and rational use of antibiotics in common infection syndrome such as urinary tract infection (UTI) is the need of the day to prevent bacterial resistance and side effects. Various protocols and guidelines are available for its use; however, perception as well as practices of clinicians may play an important role in their implementations. Methodology: To find problems as well as dilemma in regard to “when,” “what,” and “how long” to use antibiotics in UTI, a questionnaire and opinion-based study was conducted. Sixty clinicians engaged in adult internal medicine practice in Gujarat participated in the study. Many of the participants were resident doctors engaged in serving patients in the outpatient department, teaching hospitals, and medical intensive care units. Results: UTI was the second most common condition where the use of antibiotics is warranted in their practice. All of them had dilemma in the use of antibiotics because of various reasons. Majority did not ask for urine culture examination before giving antibiotics in uncomplicated UTI, but they demanded it in cases of recurrent UTIs, hospitalized patients, and pregnant patients. Their practice was akin to guidelines as far as treatment for asymptomatic bacteriuria was concerned. Fluoroquinolones and beta-lactam antibiotics were the choice of antibiotics in uncomplicated UTIs when urine culture was not ordered and was satisfied with clinical cure. Beta-lactam antibiotics were the choice in pregnant women having UTIs. Fifty-six percent responses favored 5–7-day treatment, whereas 17.86% favored 3-day treatment with fluoroquinolones or beta-lactam antibiotics. Although they were conscious and vigilant about antibiotic resistance problems, limitations did exit in their management plan which bothered them. Conclusions: Gaining insight from perceptions, knowledge, and practices of clinicians regarding the use of antibiotics in common situations such as UTI may be necessary to formulate a plan for local protocol and strategy. Antibiotic stewardship is an essential step. Shortening duration of antibiotics and use of appropriate antibiotics in different clinical situations of UTI may help to prevent antibiotic resistance. This topic needs priority in medical and paramedical education curriculum.
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CASE REPORT Top

A neonate with large oral cavity teratoma – An anesthetic challenge p. 25
G Kasirajan
DOI:10.4103/JIHS.JIHS_17_18  
An 18-day-old female baby presented with a swelling arising from the hard palate; and presenting with a difficult breast feeding and difficult airway or obstruction is a rare condition. It may range from a simple dermoid cyst to malignant neoplasms. Airway management of this baby was very difficult and quite challenging. The airway was secured with inhalation induction and spontaneous ventilation. ta
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MEDICAL EDUCATION Top

Planning and implementing an e-learning course for medical students: Points to ponder p. 28
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/JIHS.JIHS_10_19  
Due to the ubiquitous presence and use of Internet and communication technologies, e-learning has found its scope even in the field of medical education. Despite the delivery of rich collaborative community of learning, it has been observed that a significant number of enrolled participants drop out and do not complete their course. These findings clearly suggest that before designing an e-learning course for medical students, there is an immense need for having a good team, software and hardware support. The first and foremost step for designing an e-learning course is to perform a needs assessment and then followed by deciding on the content of the course. The course should be designed with periodically spaced assessments, and the students should also receive feedback about their performance and the areas in which they need to improve on. In conclusion, e-learning courses in the field of medical education have revolutionized the entire practice of teaching–learning. However, the success of an e-learning program depends on the proper planning and keeping the course interactive.
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LETTER TO EDITOR Top

Strengthening of the Health Workforce to Meet Sustainable Development Goals in India p. 30
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/JIHS.JIHS_7_19  
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