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   2021| October-December  | Volume 7 | Issue 4  
    Online since December 24, 2021

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Proceedings of the third annual women in medicine summit: An evolution of empowerment 2021
Deborah Rupert, Beatrix Thompson, Michelle Fernando, Marah Kays, Parul Barry, Shikha Jain
October-December 2021, 7(4):307-357
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The sixth annual academic international medicine virtual congress and scientific forum, May 21–23, 2021: Best practices in shifting landscapes
Annelies De Wulf, Christina Bloem, Taryn Clark, Andrew C Miller, Michael S Firstenberg, Stanislaw P Stawicki, Bonnie Arquilla
October-December 2021, 7(4):252-306
The COVID-19 pandemic continued to dominate the discourse within the Academic International Medicine (AIM) community during 2021. Although there were early signs of slow but steady pandemic recovery and the promise of “postpandemic world” was emerging, we were far from declaring victory in this healthcare battle of the century. What is certain is that our collective resilience and innovative spirit have never been more instrumental in alleviating the effects of a global calamity. With the goal of providing top-quality, highly relevant content for our membership, the American College of Academic International Medicine made a strategic decision in the late 2020 to move forward with Virtual 6th Annual Congress and Scientific Forum (AIM 2021). The theme of this year's meeting was “Best Practices in Shifting Landscapes” and reflected the rapidly changing environment we continue to operate in. Primary organization of the meeting was facilitated by the Louisiana State University Spirit of Charity Emergency Medicine Residency Program in New Orleans, with substantial contributions provided by the SUNY Downstate Medical Center team from Brooklyn, New York. The Scientific Forum was also transitioned to a virtual platform, enabling participants from around the globe to present their research. A summary of these efforts and outcomes is provided in this article. The following core competencies are addressed in this article: Interpersonal and communication skills; Professionalism; Practice-based learning and improvement; Systems based practice.
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Respiratory morbidities among wood workers: An epidemiological study from the informal sector
Aritra Kumar Bose, Dilip Dhaku Kadam
October-December 2021, 7(4):206-211
Introduction: Data on morbidities among workers working in the informal sector are scares; the current study attempts to determine the respiratory morbidities among wood workers and its severity. Materials and Methods: The study was a cross-sectional study conducted in the field practice area of a medical college's urban health center in a metropolitan city. One hundred and five wood workers from the study area were recruited by complete enumeration method. Data were collected using one to one interview method. Peak expiratory flow rate (PEFR) of every worker was measured using a peak expiratory flow meter. The data were analyzed using SPSS version 22. Results: Respiratory morbidities such as cough (61%), chest tightness (15.2%), and breathlessness (18.98%) were found among the workers. Nearly 68.56% of wood workers had abnormal PEFR. Decreased PEFR was significantly associated with lack of ventilation at the workplace, increased duration of work, use of electricity driven tools and tenure of the worker's job. Using logistic regression, we devised a model that shows abnormal PEFR is significantly dependent on work duration, hours of work per day, category of job, use of protective devices, and electrical instruments. Conclusions: The study pointed at a high prevalence of respiratory morbidities among wood workers. It also pointed out that the problem is in implementing occupational health standards already laid by international labor organizations (ILO). 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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Subgingival temperature: A forgotten cardinal sign of gingival inflammation
Dhirendra Kumar Singh, Gunjan Kumar
October-December 2021, 7(4):240-249
The first information since the 2nd century Anno Domini (AD) – when Celsius proposes “calor” (temperature) as one of the cardinal sign of inflammation, Cornelius Celsius, a nonmedico Roman from the first century, who was the first to describe the features of inflammation-redness, swelling, heat, and pain. Of all the cardinal signs of inflammation, the temperature is the only one that can be measured quantitatively and objectively. Furthermore, periodontitis is a chronic inflammatory disease and should manifest an increase in temperature in the diseased periodontium. The most challenging task in doing the diagnosis and treatment planning periodontal diseases is to predict which periodontal site the disease activity will increase. The routine clinical diagnostic parameters used for predicting and assessing periodontal disease activity are less reliable in predicting disease activity at particular sites. Periodontal pocket depth measurement is inherently inadequate because it fails to distinguish between active and inactive gingival and periodontal disease. Subgingival temperature is a more reproducible method for diagnosing periodontal disease activity, which has been forgotten by clinicians and has formed the concept for this scientific review. The following core competencies are addressed in this article: Medical knowledge, Patient care.
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The effects of temperature and outcomes of patients presenting to the emergency department with heat-related illness: A retrospective cross-sectional study
Feema Raju, Albin C Biju, Karthik Gunasekaran, Pavithra Ratnam Mannam, Krupa George, Kundavaram Paul Prabhakar Abhilash
October-December 2021, 7(4):220-225
Introduction: In a tropical country like India, heat-related illnesses are a common occurrence in the unforgiving summer months. Our study aimed to study the profile and outcome of patients with heat-related illnesses presenting to the emergency department (ED). Materials and Methods: This retrospective, cross-sectional study included all patients with heat-related illnesses to the ED during the months of April, May, and June of 2016. Baseline demographic characteristics, computed tomography (CT) brain findings, and hospital outcome were noted. Results: During the 3-month study period, 72 patients presented with heat-related illnesses. Two-thirds (46/72: 63.8%) suffered from heat stroke, whereas one-third (26/72: 36.2%) had heat exhaustion. Classical and exertional types were seen in 46% and 54% of heat strokes, respectively. The mean age (standard deviation) of the patients was 59.7 (13.3) years with a male preponderance (56.9%). Homemakers (37.5%) and manual laborers (20.8%) were most commonly affected. Hypotension at ED arrival was noticed in 20.8% (15/72), whereas tachycardia and tachypnea were noted in 80.5% (58/72) each. The findings on CT of the brain included acute infarcts (5/26: 19.6%) and an intra-cranial bleed (1/26: 3.8%). The mortality rate was 19.5% (14/72). Conclusion: Heat-related illnesses cause significant mortality during the relentless hot summers of a tropical country like India. Homemakers and manual labors were the most affected group. Acute changes were seen in CT brain of a quarter of patients with heat stroke. The following core competencies are addressed in this article: Patient care, Systems-based practice, Medical knowledge, Practice-based learning and improvement.
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What's new in academic international medicine? The gender gap in emergency medicine
Chelsea Dymond, Taryn Clark
October-December 2021, 7(4):203-205
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Clinical characteristics and complications of symptomatic bacteriuria in patients with Type 2 diabetes
Tauseef Nabi
October-December 2021, 7(4):212-219
Introduction: Patients with Type 2 diabetes have a higher prevalence of symptomatic bacteriuria, which may predispose to various complications. The aim was to study the clinical characteristics and complications of symptomatic bacteriuria in patients with Type 2 diabetes and factors associated with Escherichia coli symptomatic bacteriuria. Materials and Methods: This was a single-center observational study done on 200 Type 2 diabetes patients admitted with symptomatic urinary tract infection (UTI). Various clinical, biochemical parameters, and urine examination and culture were studied. Results: The prevalence of symptomatic bacteriuria was 69% in Type 2 diabetes patients admitted with UTI. E. coli (55%) was the most commonly isolated organism. Postmenopausal state, longer duration of diabetes, chronic kidney disease, hypertension, and history of symptomatic UTI in a prior year increase the risk of symptomatic bacteriuria. Severe hyperglycemia and acute kidney injury (AKI) occurred more frequently in bacteriuria patients as compared to without bacteriuria (P < 0.001). Upper UTI was significantly associated with symptomatic bacteriuria. Complications such as diabetic ketoacidosis, hyperglycemic hyperosmolar state, and multiorgan dysfunction syndrome were not associated with symptomatic bacteriuria. Poor glycemia, leukocytosis, glycosuria, proteinuria, renal cyst, and renal calculi correlated with symptomatic bacteriuria. Female gender, obesity, and poor glycemia were associated with E. coli symptomatic bacteriuria. Conclusions: Complications do not frequently occur in symptomatic bacteriuria except AKI. Severe hyperglycemia and uncontrolled glycemia need consideration in reducing symptomatic bacteriuria. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, and Systems-based practice.
  2,236 178 -
Resident comfort teaching and performing pediatric airway procedures after instruction using the Peyton method, standard simulation, or digital platforms
Rebecca Jeanmonod, Guhan Rammohan, Michael Grimaldi, Jonathan Pester, Holly Stankewicz, Rachel Patterson, Megan Minor, Keith Baker, Scott Melanson, Donald Jeanmonod
October-December 2021, 7(4):226-232
Introduction: Many learners use the internet or other independent means as a primary way to master procedures. There are also numerous described methods to teach procedures using simulation. The optimal method for teaching procedures is unknown. We compare residents' confidence and performance of pediatric airway skills (bag valve mask [BVM] and endotracheal intubation [ETI]) and their confidence in teaching these skills to others after training using (1) standard simulation (SS), (2) the Peyton method, or (3) self-directed learning. Materials and Methods: In 2019–2020, emergency medicine (EM) residents at a single program were randomized to one of three training groups. Prior to training, residents underwent standard airway simulation skill assessment sessions with two blinded observers. Residents in the SS group then underwent training using SS with postprocedure debriefing. Residents in the Peyton method group underwent simulation through a structured technique described elsewhere. The residents in the independent learning group were encouraged to master the skills through any means they saw fit. Residents were surveyed regarding prior experience, knowledge base, and confidence in performing and teaching procedures. Results: Thirty-three residents were randomized. After training, there were no differences between groups in comfort performing procedures. Residents randomized to independent learning were less comfortable teaching ETI than other groups. In 4–6 month follow-up, all residents showed improvement in procedural performance, regardless of assigned learner group. Conclusions: Residents using self-directed learning to master airway skills are less comfortable teaching ETI than those taught using simulation. Their skill performance is equivalent regardless of teaching method. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, Systems-based practice.
  1,936 167 -
Predictors of patient satisfaction with surgical care in a low-middle-income country
Kelechi E Okonta, Daprim S Ogaji
October-December 2021, 7(4):233-239
Introduction: Patient attending a surgical clinic may have some factors contributing to favorable satisfaction following consultations. This study is to determine the predictors of patient satisfaction with care in the surgical outpatient clinic (SOPC) of a University Teaching Hospital in a low-middle-income country. Materials and Methods: This is an analytical cross-sectional study which was conducted at the SOPC of a University Teaching Hospitals. A systematic sampling method with a sample interval of 1:2 was used to enroll respondents after consultation with a doctor using the short form of the Patient Satisfaction Questionnaire-18. The reliability test showed that the questionnaire section for overall satisfaction was acceptable (α =0.67 which was higher than the lowest acceptable threshold of 0.60 (obtained from substantial sample). Descriptive and inferential analyses were performed using the SPSS statistical software and P ≤ 0.05 was considered significant. Results: A total of 466 respondents provided complete information giving a response rate of 95.1%. About 52.8% were males and 47.2% were females. The mean age ± standard deviation was 43.2 ± 15.2. The overall level of satisfaction was 60.9%, 95% confidence interval was 59.7–62.0, and the predictors for overall patients' satisfaction were male gender, older age of patient, higher monthly income, higher self-rated health status, and beneficiaries of free health care. Conclusion: The level of patients' satisfaction with quality of surgical care was high and the identified predictors being male, free health care, and patients' self-rating of health status. The following core competencies are addressed in this article: Interpersonal and communication skills, Patient care, Practice-based learning and improvement, Systems-based practice.
  1,737 153 -
Point-of-care lung ultrasound and early detection of pneumothorax in a COVID-19–positive patient undergoing noninvasive ventilation therapy
Deepak Dwivedi, Sonia Bhan, Debashish Paul, Bhavna Hooda
October-December 2021, 7(4):250-251
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