Residents In India Research Articles

Impact of the COVID-19 Pandemic on Gastroenterology Training in India

Abstract Introduction The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare system. The residents who are at the frontline of this pandemic have suffered the most. The extent of the training loss due to the COVID-19 pandemic on gastroenterology (GE) training is not studied in India. Methods We designed a 36-question based google survey and distributed it to the GE residents all across India, via email. All the responses collected were analyzed using appropriate statistical methods. Results A total of 140 responses were received. No significant decrease in teaching sessions/ classes was reported. Most of the residents (83.5%) reported inability to complete the target thesis enrolment. The number of patients seen by the residents in outpatient department, patients managed in wards and endoscopic procedures done by residents have decreased significantly (p-valve <0.001 for all). An overwhelming 89.9% (n = 125) of the GE residents were posted for COVID-19 duties. Almost half (50.4%) of them were COVID-19 positive. Conclusion The COVID-19 pandemic has affected the training of GE residents in India immensely and an extension period of 3 months may be offered to them.

Societal awareness regarding viral Hepatitis in developed and developing countries

Acute viral hepatitis is a condition in which healthy liver tissue gets inflamed, whereas chronic viral hepatitis can reach the point of cirrhosis and sometimes end-stage liver cancer. The disease, in its chronic form, causes detrimental amounts of scar tissue that stifle the liver's functionality and leads to organ failure. Many cases of viral hepatitis are easily preventable if caught early; however, a lack of public awareness regarding often leads to diagnoses near the final stages of disease when it is most lethal. Thus, we wanted to understand to what extent an individual's sex, age, education and country of residence (India or Singapore) impacts disease identification. We sent out a survey and quiz to residents in India (n = 239) and Singapore (n = 130) with questions that test their knowledge and awareness of the disease. We hypothesized that older and more educated individuals would score higher because they are more experienced, but that the Indian population will not be as knowledgeable as the Singaporean population because they do not have as many resources, such as socioeconomic access to schools and accessibility to healthcare, available to them. Additionally, we predicted that there would not be any notable differences between make and females. The results revealed that the accuracy for all groups we looked at was primarily below 50%, demonstrating a severe knowledge gap. Therefore, we concluded that if more medical professionals discussed viral hepatitis during hospital visits and in schools, patients can avoid the end stages of the disease in notable cases.

Impact of COVID-19 Pandemic on Pathology Residency Program: An Experience from India.

To study the impact of the COVID-19 pandemic on pathology residents through a questionnaire-based survey. We designed a Google survey questionnaire with 20-questions and distributed it to the pathology residents across India via e-mail and WhatsApp. All the responses collected were analysed using appropriate statistical methods. We received a total of 81 responses. The majority (n=55, 68.8%) of the residents were aged 26-30 years with a male-female ratio of 1:2.2. Residents reported a significant decrease in classes as compared to pre-covid times. However, most institutions (90%) shifted to the virtual method for various teaching sessions. About 94.7% of the residents felt a fall in the quality of training due to Covid. A significant number of junior residents (76.92%) reported an inability to complete the target thesis enrolment. The residents saw a substantial decrease in the number of peripheral smears, bone marrow, cytology, and histopathology cases compared to pre-Covid times (p value < 0.001 for all). An overwhelming 83.8% of the pathology residents were posted for COVID-19 duties. About 48.8% turned Covid positive. About 77.5% (n=62) of residents felt that the necessary training period would be extended. The COVID-19 pandemic has immensely affected the training and teaching of pathology residents in India. Similarly, this pandemic must have affected pathology residents all across the globe. Therefore, institutions can consider offering an extended period of up to one year, depending upon residents' requests.

Effect of Sleep Deprivation on Mood States of Junior Residents in Obstetrics and Gynaecology Department: A Prospective Observational Study

Introduction: Junior residents of highly demanding clinical specialties, like, Obstetrics and Gynaecology, are an integral part in the functioning of hospitals. They work round the clock donning the role of caregiver as well as learner and are in a constant state of stress. Any alteration in mood while working in intensive set ups like labor room and operation theatre can adversely affect not only the physician’s performance but also patient safety. Aim: To evaluate the effect of sleep deprivation on mood states of junior residents in Obstetrics and Gynaecology Department during call duty. Materials and Methods: This prospective observational study was conducted in Department of Obstetrics and Gynaecology at Armed Forces Medical College (tertiary care hospital), Pune, Maharashtra, India, from march 2019 to august 2019. The study included 37 junior residents of Obstetrics and Gynaecology Department, between age range of 25-40 years. Sleep diary was used to record resident’s sleep patterns, Karolinska Sleepiness Scale (KSS) was used to assess the day time sleepiness. Profile of Mood States (POMS) score was calculated during pre-call and post-call duty. This data was used to ascertain any changes in mood post-call due to sleep deprivation. Statistical analysis was done using paired Student’s t-test and Wilcoxon Signed Rank test and p-value &lt;0.05 was considered as significant. Results: Out of 37 participants, 21 were males and 16 females. There was a significant worsening of post-call POMS score (5.24±27.82) from pre-call score (-6.86±23.70) following call duty associated with a decrease in mean night time sleep (p-value&lt;0.001). Likewise increased KSS score was also noted after call duty (pre-call score was 3.03±1.65 vs post-call score was 5.73±2.05; p-value&lt;0.001). This signifies that mood states are adversely affected by sleep deprivation in these residents. Conclusion: The study showed that there was a significant worsening of mood states due to sleep deprivation during call duties. This also mandates review of efficacy and feasibility of current policy regulating work hour schedule of junior residents in India.

Impact of COVID-19 on orthopaedic residents-an Indian perspective.

Objectives:The COVID-19 pandemic is a public health emergency causing a deleterious effect on the health system. It affected all the specialties and subspecialties in the medical field causing havoc in the health institutions. This pandemic affected both orthopaedic consultants and the residents who are under training. Our purpose was to study the impact of COVID-19 on orthopaedic residents in their professional life.Method:The study design was a computer-based digital online survey of the orthopaedic residents in India. The survey had 15 questions with multiple options related to the effect of COVID-19 on their orthopedic department, effect on teaching, surgical exposure, hands-on surgeries, the effect on workload, effect on mental stress, exposure to arthroplasty, arthroscopic surgeries, spine surgeries, and deformity correction surgeries.Results:Elective surgeries stopped in 91% of the hospitals, academic teaching stopped in 98% of the institutions. Eighty-six percent of the residents are not getting adequate surgical exposure, 73% of the residents are getting negligible hands-on surgical training. Residents are mentally stressed related to academic examinations, academic training, and also because of COVID 19 duties. Residents are getting the least exposure in subspecialties like arthroplasty, arthroscopy, and spine.Conclusion:The COVID-19 pandemic not only affected the orthopaedic consultants but also the orthopaedic residents to a great extent as residents are the backbone of any department/institution. The pandemic affected significantly resident's academic teaching, surgical exposure, hands-on training and mental stress related to COVID duties, academic training disturbance, and also academic examinations.

Prevalence of undernutrition and effectiveness of a community-based nutritional support programme to reverse stunting among children under five years of age in an urban slum in Kolkata, India: findings of a one-year longitudinal study

Background Stunting, defined as z-score height-for-age (HAZ) &lt; -2, is an important contributor to the burden of childhood undernutrition among slum-dwelling residents in India’s metropolitan areas. Calcutta Rescue (CR) is a non-governmental organisation that provides medical care and nutritional support to slum-dwellers in Kolkata, India. CR undertook a study in Liluah Bhagar, an urban slum, to 1) establish the prevalence of undernutrition among children under five years of age, 2) evaluate the impact of a pilot nutritional support programme on growth patterns of a consecutively selected group of stunted children, and 3) identify socio-economic predictors of stunting. Methods For the prevalence assessment (April-June 2018), we conducted anthropometric measurements using standardised World Health Organization (WHO) growth measurements for weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WFH). For the longitudinal study, we recruited stunted children and collected anthropomorphic data every three months for one year (December 2018-December 2019). Results The prevalence assessment of 116 children revealed 59% of stunting, 44% underweight and 12% of wasting. Follow-up of 42 stunted children in a pilot nutritional programme improved stunting over time (b =0.07, 95% CI 0.05 to 0.039, P&lt;0.001), with a trend towards clinical improvement at one year. Linear mixed model analysis revealed household income was a negative predictor of stunting (b =-0.38, 95% CI -0.66 to -0.09, P=0.010). Conclusions This study highlights the burden of undernutrition in marginalised slum-dwelling children in India and the benefits of a pragmatic, education-focused nutritional intervention programme. Further studies are required to determine what predictors other than income are associated with stunting to then determine what interventions are likely to effect long-lasting and sustainable changes to growth in this vulnerable population.

Enhancing communication skills among residents in India: An interprofessional education approach

BackgroundInterprofessional education (IPE) provides opportunities to postgraduates to develop communication skills which are vital for interactions with patients, their relatives, colleagues, paramedical and nursing staff. There is a need to develop an innovative IPE based module on communication skills for postgraduates stressing upon the existing lacunae and requirements detected by a validated assessment tool. We assessed the residents' appraisal of communication skills by a validated questionnaire to identify key areas to improve their communication skills and to determine perceptions of all the stakeholders i.e. faculty, nursing staff and paramedical staff. MethodsA descriptive correlational design using an online self-administered questionnaire on a sample of a total of 200 participants comprising residents, paramedical staff, nursing staff and faculty of tertiary care hospital. Study was approved by the Institutional Ethical Committee. Data was analysed by SPSS Version 22.0 used. (p value < 0.05 significant). ResultsThe participants included 113 residents, 17 paramedical staff, 33 Nursing staff and 37 faculty members. The present study found a significant difference of scores of means between the residents, faculty, paramedical staff and nursing staff p value < 0.05 except for alter centrism, interaction management and environmental control. The mean scores were also significantly different between the first, second and third year residents. ConclusionThis study validates the need to enhance the communication skills of residents. The scores obtained will help us design and refine IPE module for the benefit of the residents.

The Impact of Cultural Festivals on Subjective Well-being of The Visitors: Case Study of Alva's Virasat, A National Cultural Festival in India

This research examined the relationship between cultural festival experience and subjective well-being among festival attendees. In this connection, this study captured the perceptions of 192 festival attendees' attending the cultural festival of "Virasat" in India on the four subdimensions of festival experiences (i. e., music experience, festival atmosphere, social experience, separation experience) and subjective well-being. Accordingly, this study adopted structural equation modeling (SEM) and hierarchical regression analysis to examine the relationship between the study constructs. Results that emerge from this study point towards the presence of a significant positive relationship between cultural festival experience and subjective well-being. Furthermore, of the four dimensions of festival experience, music experience and separation experience, in that order, were found to be the most potent predictors of subjective well-being. Social experience and festival atmosphere only minimally augmented predictability of subjective well-being over and above music experience and separation experience. Accordingly, the findings of this study are expected to aid cultural festival organizers to design events that elicit exhilarating festival experiences that, in its turn, is expected to augment subjective well-being among event attendees. Drawing extensively from subjective well-being research in India that suggests factors like sociodemographics, personal characteristics, economic conditions, and purchasing power parity contribute only moderately, if not significantly, to the levels of subjective well-being among the residents in India, the findings of this study situates cultural festival experience as a possible trigger that augments subjective well-being among Indians in a collectivist cultural context.

Knowledge of the Culture of Safety in Cholecystectomy (COSIC) Among Surgical Residents: Do We Train Them Well For Future Practice?

Biliary injury is the most feared complication of laparoscopic cholecystectomy (LC). This study aimed to assess the awareness of culture of safety in cholecystectomy (COSIC) concept among the surgical residents in India. A manual survey was conducted among general surgery residents attending a postgraduate course. Survey consisted of questions pertaining to knowledge of various aspects of COSIC, e.g., the critical view of safety (CVS). With a response rate of 51%, 259 residents were included in this study. They had more exposure to LC (63.3% assisted / performed > 15 LC) than to open cholecystectomy (60.6% assisted / performed ≤ 10 open cholecystectomy). The majority (80.2%) clearly differentiated Calot triangle from the hepatocystic triangle (HCT). However, 25.8% could not correctly define HCT. Themajority (88.5%) had seen the Rouviere's sulcus during LC. While almost all (98.4%) respondents claimed to know about thesegment 4, only 41.9% could correctly describe it. Awareness of the correct direction of thegallbladder retraction was lower for the infundibulum (53.5%) than for fundus (89.2%). Themajority (88.3%) claimed to know CVS but only 11.5% knew it correctly, and 15.1% described > 3 components. Themajority (78.7%) practiced to identify thecystic duct-common bile duct junction. Awareness was low for time-out (28.1%), intraoperative cholangiography (20.6%), bailout techniques (18.9%), and for overall COSIC concept (15.7%). Knowledge of COSIC among surgical residents seems to be suboptimal, especially for theCVS, time-out, bailout techniques, and overall concept of COSIC. Strategies to educate them more effectively about COSIC are highly imperative to train them well for future practice.

Knowledge, Attitude, and Practice about informed consent amongst Resident doctors at Rural Medical Institute of Central India

Informed consent is the process by which the treating health-care provider discloses appropriate informationto the patient so that the patient may make a voluntary choice to accept or refuse treatment. There are fewstudies done amongst the medical residents in India about informed consent. The residents are the steppingstone of the Medical profession, it is proposed that the perception about the informed consent amongstthe residents shall be sought. Hence, the study was undertaken with the aim, to appraise the knowledge,attitude, and practices of residents of all three years toward ‘informed consent taking’ with the objectives ofassessing and comparing the knowledge, attitude and practices of obtaining informed consent. The surveyquestionnaire was circulated and data was collated. It was developed in Knowledge, Attitude and practicedomain and analysis was done. Based on the result, it was concluded that, in all three domains, there wasascendency of Knowledge, Attitude and Practice in three years of resident doctors.

Prevalence and effectiveness of innovative techniques in ophthalmic surgical training during COVID-19 pandemic in India.

Purpose:This study aimed to determine the various innovative surgical training techniques prevalent among ophthalmology residents in India during the COVID-19 pandemic.Methods:This was a prospective cross-sectional study. An online survey questionnaire was completed by ophthalmology residents from different parts of the country. The survey consisted of questions related to the impact of the pandemic on training, innovative training techniques adapted during the pandemic and their effectiveness, and COVID-19 duty-related information.Results:A total of 147 responses were obtained. The mean age was 29.3 years (range: 24–40 years, SD: ±3.82). Of which, 87 (59.2%) respondents were females. A total of 61 (41.5%) respondents reported practicing steps of ocular surgeries on goat eye, 69 (46.9%) on model eye/vegetables/fruits, 30 (20.4%) on surgical simulators, and 26 (17.7%) utilized 3-D virtual images and videos. In addition, 22 (15%) respondents reported never using any such techniques. Furthermore, 130 (88.4%) respondents reported practicing steps of cataract surgery, 52 (35.4%) practiced steps of open globe repair, and steps of trabeculectomy were reported by 24 (16.3%). The steps that were reported to be practiced most are incision or tunnel construction by 108 (73.5%), suturing by 92 (62.6%), capsulorrhexis by 91 (61.9%), primary wound repair by 82 (55.8%), and conjunctival peritomy by 75 (51%).Conclusion:The present study demonstrates that residents across the country are adapting to the present scenario by utilizing several innovative methods to sharpen their surgical acumen. The current pandemic situation can serve as an impetus to emphasize upon the institutes and medical regulatory bodies to appropriately remodel the residency curriculum.

Assessment of Knowledge Activity Practice (KAP) Towards COVID-19 Pandemic

Unprecedented measures to control the rapid spread of India 's ongoing COVID-19 pandemic have been adopted. Knowledge, Activity and Practice (KAP) toward COVID-19 influence people 's adherence to control steps. Through this report, we investigated Indian KAP residents against COVID-19 during the rapidly growing outbreak time. An online sample of Indian residents has been successfully recruited with residents in India through the authors' networks. The participants completed a self-developed online questionnaire on KAP. The knowledge questionnaire consisted of 12 questions concerning the clinical characteristics and COVID-19 prevention. Assessments on the attitudes and practice of citizens towards COVID-19 contained questions on confidence in winning the fight against COVID-19 and wearing masks while going out in the last few days. The COVID-19 knowledge score (OR: 0.75-0.90) has been significantly correlated in multiple logistic regression analyzes with a lower likelihood of fewer knowledge and negative attitude and preventive practices towards COVID-2019.Most Indian residents of a relatively high socioeconomic status, particularly women, are knowledgeable about COVID-19, hold positive attitudes, and have adequate COVID-19 practices. Health awareness initiatives aimed number of information about COVID-19 are valuable for Indian citizens in preserving positive attitudes and effective practices. We must be careful when generalizing these results to communities of low socioeconomic status due to the small sample representativeness.

Burnout among Plastic Surgery Residents in India: An Observational Study.

Introduction Burnout syndrome can be defined as emotional exhaustion, depersonalization, and perceived lack of personal accomplishment, all of which lead to decreased effectiveness at work. The Medscape burnout and depression report of 2018 suggests that the burnout range across various specialties ranges from 23 to 48%. There are no studies to assess the burnout among plastic surgery residents in India. This study is an attempt to assess the same. Materials and Methods An online survey was conducted in March and April 2019 for plastic surgery residents across India. Various parameters including those related to gender, year of the curriculum, hobbies, exercise, and marital status were assessed. There were multiple sections in the survey, which included the demographic details, stress-related variables, and the abbreviated Maslach Burnout Inventory. The abbreviated Maslach Burnout Inventory is a validated scale that has been used to assess the burnout among plastic surgery residents in India. The three subscales, emotional exhaustion, depersonalization, and personal accomplishment were measured on a Likert scale. Univariable and multivariable analysis of factors associated with burnout was performed. Results Of the 185 respondents, 48.4% experienced moderate-to-high burnout. Of these, 25% ( n = 46) were above the 75th centile of the overall burnout score, indicating severe burnout. Insufficient faculty involvement, insufficient time allotted for formalized teaching, conflict with colleagues, and lack of adequate support staff correlated with resident burnout on multivariate analysis. Residents who pursued their hobbies or performed physical activities for exercise had significantly lesser burnout. Conclusion The incidence of burnout in plastic surgery residents surveyed in our study was 48.4%. The faculty of the departments and the residents themselves, as well as the governing bodies, all have a role to play to address the issue of burnout among residents. Dedicated and persistent efforts toward improving physical and psychological well-being of plastic surgery residents will positively impact not only the well-being of the residents but also the quality of patient care.

Book review: CityMakers: Tribulations &amp; Triumphs – A Saga of Heroic Struggles of the Homeless Residents in India

Book review: CityMakers: Tribulations &amp; Triumphs – A Saga of Heroic Struggles of the Homeless Residents in India

An Affordable Neurosurgical Training System for Neurosurgical Residents; The Indian Perspective.

Neurosurgical training in India. To establish a sustainable, functional, and relatively inexpensive neurosurgical training system. The training system involved using a relatively inexpensive stereoscopic microscope and ophthalmological microinstruments , including two jewellers' forceps and a microscissors. Training modules were designed using commonly available materials such as gauze, latex gloves, and chicken wings. None. The system proved to be easy to construct, easy-to-use, and highly compact. This system allowed for residents to practice microsuturing and vessel anastomosis and allows the resident to be familiarized with operating under the microscope. Thereby , developing the hand-eye coordination and precise motor control required for neurosurgery as well as the art of appropriate tissue handling. The inexpensive nature of this training system and its inherent simplicity allows for a larger portion of neurosurgical residents in India, without access to sophisticated skills labs, to practice their skills in a controlled environment, without compromising on their ward duties.

Knowledge of the Culture of Safety in Cholecystectomy among Surgical Residents in India: Do We Train Them Well for Future Practice?

Knowledge of the Culture of Safety in Cholecystectomy among Surgical Residents in India: Do We Train Them Well for Future Practice?

Examining cultural impacts on consumers’ environmental CSR outcomes

PurposeThe purpose of this paper is to examine the impact of cultural factors on environmental CSR attitudes and purchase intentions among publics in a developed (USA) country and a developing (India) country.Design/methodology/approachUsing a 2 (location of the company: India vs USA) × 2 (location of the CSR activity: India vs USA) between-subjects experimental design, the study examines individuals’ attitudes and behavioral intentions toward a company’s environmental CSR activities in each respective country.FindingsTwo structural equation models were created for US publics and Indian publics. Results indicated that cultural factors, specifically the uncertainty avoidance dimension, play an important role among both Indian and US residents’ attitudes toward a company’s environmental CSR efforts and their intention to purchase its products/services. Among Indians, the power distance dimension acted as a mediating factor.Originality/valueThis study is novel in its examination of the impact of cultural factors among residents in India and the USA. This information can be utilized by multinational companies to implement effective CSR activities and enhancing their global CSR communication efforts.

Heavy metals pollution assessment and its associated human health risk evaluation of urban soils from Indian cities: a review.

Urban soils of 32 Indian cities were collected from literature-based data for the period of 2001-2019 to measure the contamination levels of six heavy metals including arsenic (As), chromium (Cr), copper (Cu), zinc (Zn), nickel (Ni), and lead (Pb) and also evaluated the potential human health risk for adults and children. The results indicated that concentrations of six heavy metals in the urban soils were much higher than both geochemical background values (Grade-I) and also Canadian soil quality guideline values (Grade-II) in most of the cities in India. Higher concentration of Cr and Ni was in cities mainly located in southern (Karnataka), northern (Uttar Pradesh), and eastern (Odisha); As and Pb primarily in central (Telangana), while Zn and Cu largely in western (Maharashtra) and eastern (Jharkhand) states of India, respectively. The index of geo-accumulation (Igeo) values varied largely and showed moderately polluted to extremely polluted levels, possibly caused/influenced by anthropogenic activity in the urban regions in India. The non-carcinogenic health risk due to Cu, Zn, Ni, and Pb in most urban regions was lower than the threshold value (HI < 1), indicating no non-carcinogenic health risk for adults and children. As and Cr on children, non-carcinogenic risk was very higher than that of adults, and their risk values were also exceeded the threshold value, indicating that As and Cr in the urban soils posed considerable non-carcinogenic health risks on urban residents. The total carcinogenic/cancer risk due to Pb in most urban regions was lower than the recommended limit of 1.00E-04, while Cr and As have shown potential cancer risk for both adults and children. Therefore, As and Cr are the sole heavy metals that cause potential health risk in an urban region residents in India, which needs to be paid more attention and also controlling measures should be initiated.

Public Goods, and Nested Subnational Units: Diversity, Segregation, or Hierarchy?

We develop a general multi-scale framework to account for spatial segregation of hierarchically-ordered ethnic groups residing in politically and administratively nested geographic aggregations. We explicate how ethnic diversity, ethnic segregation, and ethnic hierarchy interact with the goods catchment area to cast doubt on extant hypotheses linking and public goods provisioning. We not only show how the celebrated diversity debit relationship is incomplete at best but also call into question the more recent literature that posits a positive association between ethnic segregation and public goods. We test our framework using a large national census dataset containing ethnicity information (aggregate caste categories) for 830 million rural residents in India. Our nested-geography models use data from villages (n 600; 000) and sub-districts containing these villages (n 6; 000) for twenty-five different public goods. We show how not accounting for the spatial structure of diversity, segregation, and hierarchy result in biased empirical models of and public goods. To the best of our knowledge, the empirical evidence in this paper comes from the largest dataset used in the politics of public goods literature.

The Aadhaar debate

The Aadhaar project which aims to provide all residents in India with a unique identity number requires much more attention from sociologists of India. There are several areas of research where sociologists can help: one, the implications of new technologies of surveillance for (a) privacy and (b) society; two, the repercussions of the desire for social ordering and control and technocratic solutionism for people in their interactions with the state demands fuller sociological study. This brief note attempts to outline some of the issues that call out for enquiry.