Extent of awareness and attitudes on plagiarism among post-graduate resident doctors and junior medical faculty in India: a cross-sectional, multicentric study

ObjectivesThough dissertation is mandatory for postgraduates (PG), it is unknown if adequate knowledge on plagiarism exists at that level. Thus, we intended to study the knowledge and attitude towards plagiarism among junior doctors in India.DesignCross-sectional studySettingPG medical residents and Junior faculty from various teaching institutions across south India.ParticipantsA total of N=786 doctors filled the questionnaires of which approximately 42.7% were from government medical colleges (GMCs) and the rest from private institutions.MethodsParticipants were given a pretested semistructured questionnaire which contained: (1) demographic details; (2) a quiz developed by Indiana University, USA to assess knowledge and (3) Attitudes towards Plagiarism Questionnaire (ATPQ).Outcome measuresThe Primary outcome measure was knowledge about plagiarism. The secondary outcome measure was ATPQ scores.ResultsA total of N=786 resident doctors and junior faculty from across 11 institutions participated in this study. Of this, 42.7% were from GMCs and 60.6% were women. The mean (SD) knowledge score was 4.43 (1.99) out of 10. The factors (adjusted OR; 95% CI; p value) that emerged as significant predictors of knowledge were number of years in profession (−0.181; −0.299 to –0.062; 0.003), no previous publication (0.298; 0.099 to 0.498; 0.003) and working in a GMC (0.400; 0.106 to 0.694; 0.008). The overall mean (SD) scores of the three attitude components were: Permissive attitudes—37.33 (5.33), critical attitudes —20.32 (4.82) and subjective norms—31.05 (4.58), all of which corresponded to the moderate category.ConclusionParticipants lacked adequate knowledge on how to avoid plagiarism suggesting a need for a revamp in medical education curriculum in India by incorporating research and publication ethics.

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Do consultants do what they say they do? Observational study of the extent to which clinicians involve their patients in the decision-making process

BMJ Open ◽

10.1136/bmjopen-2021-056471 ◽

2022 ◽

Vol 12 (1) ◽

pp. e056471

Author(s):

Ellen M Driever ◽

Anne M Stiggelbout ◽

Paul L P Brand

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Patient Involvement ◽

Secondary Outcome ◽

Junior Doctors ◽

Secondary Outcome Measure ◽

Shared Decision ◽

Preference Scale ◽

Cross Sectional ◽

Sectional Analysis

ObjectivesTo assess whether consultants do what they say they do in reaching decisions with their patients.DesignCross-sectional analysis of hospital outpatient encounters, comparing consultants’ self-reported usual decision-making style to their actual observed decision-making behaviour in video-recorded encounters.SettingLarge secondary care teaching hospital in the Netherlands.Participants41 consultants from 18 disciplines and 781 patients.Primary and secondary outcome measureWith the Control Preference Scale, the self-reported usual decision-making style was assessed (paternalistic, informative or shared decision making). Two independent raters assessed decision-making behaviour for each decision using the Observing Patient Involvement (OPTION)5 instrument ranging from 0 (no shared decision making (SDM)) to 100 (optimal SDM).ResultsConsultants reported their usual decision-making style as informative (n=11), shared (n=16) and paternalistic (n=14). Overall, patient involvement was low, with mean (SD) OPTION5 scores of 16.8 (17.1). In an unadjusted multilevel analysis, the reported usual decision-making style was not related to the OPTION5 score (p>0.156). After adjusting for patient, consultant and consultation characteristics, higher OPTION5 scores were only significantly related to the category of decisions (treatment vs the other categories) and to longer consultation duration (p<0.001).ConclusionsThe limited patient involvement that we observed was not associated with the consultants’ self-reported usual decision-making style. Consultants appear to be unconsciously incompetent in shared decision making. This can hinder the transfer of this crucial communication skill to students and junior doctors.

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Comparative study on management of acute moderate and severe lateral ankle sprain using immobilization in below knee slab versus stirrup ankle brace

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i1.17208 ◽

2017 ◽

Vol 18 (1) ◽

pp. 10-16

Author(s):

Prawesh Singh Bhandari ◽

G. KC ◽

S. Uprety

Keyword(s):

Ankle Joint ◽

Outcome Measure ◽

Functional Improvement ◽

Secondary Outcome ◽

Lateral Ligament ◽

P Value ◽

Secondary Outcome Measure ◽

Joint Function ◽

Ankle Brace ◽

Significant Difference

Introduction: Amongst musculoskeletal injuries, ankle ligament sprains are the single most common sports injury. However, there often appears to be no common regimen for their management, with a wide spectrum of treatment options available. The purpose of this study is to determine the functional outcome of the ankle joint after a moderate or severe inversion injury, comparing standard treatment with a Below Knee Slab Splint against a Stirrup ankle brace.Method: Prospective study conducted at the emergency department at Tribhuvan University Teaching Hospital. Fifty patients presenting consecutively were randomized into two equal groups: one group was treated with Below Knee Slab Splint and the other with an Stirrup ankle brace. All patients were given a standardized advice sheet referring to rest, ice, compression, and elevation, NSAIDS and support. Patients were reviewed after 48–72 hours, 14 days, and 3 week. Primary outcome measure: Ankle joint function assessed at 3 week using the modified Karlsson scoring method (maximum score 90). Secondary outcome measure: The difference in ankle girth (swelling) at 3 weeks. Results: Twenty-five patients in Below Knee Slab Splint group and twenty-five patients in the stirrup ankle brace group. The age of the patients ranged from 16 to 55 years with the mean of 30.68±9.33 years.The difference in mean age in years was not different in both groups (P>0.05).The distribution of gender and occupation in both groups were homogeneous (P>0.05). The karlsson’s score mean for brace group is 79.8±5.3 and for other group is 72.0±10.3 (p-value: 0.002). Thus there was a significant difference in Karlssons score between the two groups showing better functional improvement in patients receiving Stirrup ankle brace. There is significant difference in the swelling of clients in between application of the brace (1.00±0.48 and slab (1.70±0.50) the at end of the third week with p value 0.000.Conclusion: The use of Stirrup ankle brace for the treatment of lateral ligament ankle sprains produces a significant improvement in ankle joint function at three weeks compared with standard management with aimmobilization in below knee posterior slab splint.JSSN 2015; 18 (1), Page: 10-16

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Opioid use disorder in chronic non-cancer pain in Germany: a cross sectional study

BMJ Open ◽

10.1136/bmjopen-2018-026871 ◽

2019 ◽

Vol 9 (4) ◽

pp. e026871 ◽

Cited By ~ 9

Author(s):

Johannes Maximilian Just ◽

Fabian Schwerbrock ◽

Markus Bleckwenn ◽

Rieke Schnakenberg ◽

Klaus Weckbecker

Keyword(s):

Cancer Pain ◽

Outcome Measure ◽

Primary Outcome Measure ◽

Opioid Use Disorder ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Opioid Use ◽

Cross Sectional ◽

Pain Clinics ◽

Severe Disorder

ObjectivesThe DSM-5 diagnosis ‘opioid use disorder’ (OUD) was established to better describe and detect significant impairment or distress related to opioid use. There is no data on rates of OUD in chronic non-cancer pain (CNCP) in European countries. Therefore, our objective was to screen patients in specialised pain centres for signs of OUD.DesignCross-sectional questionnaire study.SettingFour outpatient pain clinics in the area of Bonn, Germany.Participantsn=204 patients participated in the study (response rate: 87.9%). All adult patients with opioid pain therapy >6 months for CNCP were included. Excluded were patients with malignant disease, patients who could not collect their prescription themselves due to age or multimorbidity and patients on opioid-maintenance therapy.Primary and secondary outcome measurePrimary outcome measure was the proportion of patients with mild to severe OUD.ResultsOne-fourth (26.5%) of participants were diagnosed with OUD. Moderate to severe disorder was found in 9.3. Young age was the only connected risk factor (OR 0.96 [95% CI 0.94 to 0.99], p: 0.003).ConclusionsOUD is a relevant diagnosis in patients on long-term opioid therapy for CNCP in the Bonn area. Careful follow-up by the attending physicians is advisable, especially in patients with moderate or severe disorder.

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Frequent Hospital Users with Limited English are Vulnerable to COVID-19 Misinformation: Results from A Cross-sectional Survey

10.21203/rs.3.rs-1094007/v1 ◽

2021 ◽

Author(s):

RL Jessup ◽

C Bramston ◽

P Putrik ◽

C Haywood ◽

M Tacey ◽

...

Keyword(s):

Limited English Proficiency ◽

English Proficiency ◽

Relevant Information ◽

World Health ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Misleading Information ◽

Adequate Knowledge

Abstract BackgroundSuccessful public health responses to pandemics rely on individuals being able to access, clearly understand and easily interpret relevant information about symptoms, prevention, testing and containment strategies. Accessing and interpreting information during the pandemic has been difficult for many populations, particularly those experiencing social or economic disadvantage. The aim of this study was to understand how a population of frequent hospital users originating, from a disadvantaged population, have accessed and interpreted information during the COVID pandemic in Melbourne.MethodsCross sectional telephone survey of 200 frequent hospital users (115 with limited English proficiency) informed by the World Health Organisation’s “Rapid, simple, flexible behavioural insights on COVID-19”. Primary outcome measures included knowledge of symptoms, preventive strategies, government restrictions aimed at containment, and belief in misleading information. Secondary outcome measure was perceived trustworthiness of information which was measured using content analysis of open-ended questions. ResultsOverall, the survey participants had poor understanding of misleading information (69%). 41.2% were unable to accurately identify symptoms, while 35.8% were unable to identify preventative strategies. Just under 1/3 (30.2%) were unable to describe government restrictions. English-speaking participants were almost three times (OR 2.69, 95%CI 1.47;4.91) more likely tohave adequate knowledge about symptoms, were twice as likely to understand local restrictions (OR 2.10 95%CI 1.06; 4.19) and were 11 times more likely to recognise information that was misleading or incorrect (OR 11.52 95%CI 5.39; 24.60) than those with limited English. 50% of those surveyed stated that theytrusted all information that they read or heard, with on 20% stating that they were uncertain or untrusting of some information.ConclusionLimited English proficiency was strongly associated with inadequate knowledge of COVID-19 and much greater likelihood of believing widely circulating misinformation. In order to reduce transmission, morbidity and mortality associated with COVID-19, health authorities must tailor health messaging to disadvantaged populations to ensure they have adequate access, and understanding, of the information.

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Success of trabeculectomy surgery in relation to cataract surgery: 5-year outcomes

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312972 ◽

2018 ◽

Vol 103 (10) ◽

pp. 1395-1400 ◽

Cited By ~ 2

Author(s):

Rashmi G Mathew ◽

Sahar Parvizi ◽

Ian E Murdoch

Keyword(s):

Cataract Surgery ◽

Outcome Measure ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Risk Of Failure ◽

Increased Risk ◽

Significant Difference ◽

Measure Change ◽

Group 2

AimsTo compare success proportions at 5 years in three surgical groups: group 1, trabeculectomy alone; group 2, trabeculectomy followed by cataract surgery within 2 years; and group 3, trabeculectomy performed on a pseudophakic eye.MethodsA retrospective cohort study. 194 eyes of 194 patients were identified with at least 5 years’ follow-up post trabeculectomy (N=85, 60 and 49 in groups 1, 2 and 3, respectively).Main outcome measures1. Primary outcome measure: intraocular pressure (IOP) at 5 years post-trabeculectomy surgery, 2.Secondary outcome measure: change in visual acuity at 5 years.ResultsAt 5 years, the mean IOP (SD) was 12.9 (3.5), 12.5 (4.8) and 12.7 (4.8) mm Hg in groups 1, 2 and 3, respectively. Overall success was almost identical, 58%, 57% and 59% in groups 1, 2 and 3, respectively. There was no significant difference between the groups in terms of percentage IOP reduction, number of medications, proportion restarting medication and reoperation rates at 5 years. Logistic regression for an outcome of failure showed men to be at increased risk of failure OR 1.97 (95% CI 1.10 to 3.52, p=0.02). Nearly 80% of patients retained or improved their vision following their initial trabeculectomy.ConclusionsThe sequence in which surgery is carried out does not appear to affect trabeculectomy function at 5 years, success being similar to trabeculectomy alone. In our study, men may be at increased risk of failure.

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Economic implications of polypharmacy in Nepal: Multicenter community-based study

10.1101/2020.09.12.20193458 ◽

2020 ◽

Author(s):

Binaya Sapkota ◽

Suraj Shakya ◽

Saroj Sah ◽

Narendra Chaudhary ◽

Bijendra Tamang ◽

...

Keyword(s):

Drug Interactions ◽

Multinomial Logistic Regression ◽

Statistical Significance ◽

Age Groups ◽

Pharmacoeconomic Evaluation ◽

Secondary Outcome ◽

P Value ◽

Cross Sectional ◽

Economic Implications ◽

Total Cost

Objective:Improper management of polypharmacy in community and hospital pharmacies may lead to adverse effects and drug interactions in patients of all age groups, especially children and the elderly. This study aimed to determine the scenario of polypharmacy in multiple communities in Nepal and the costs associated with them. Design: Cross-sectional study Setting:Local communities of nine districts in Nepal Participants:Total 400 patients of all age groups, who were consuming medicines and who fulfilled inclusion criteria from May 2017 to August 2018 Primary and secondary outcome measures:A semi-structured questionnaire, based on the prescription optimization method, was used for data collection. Multinomial logistic regression was performed to analyze the statistical significance of polypharmacy with the predictor variables (e.g., age, education level, occupation, diagnosis, total cost of medicines). The p-value <0.05 was considered statistically significant at 95% confidence interval. Polypharmacy cases and their economic implications were reported. Results:Eighty-one patients (20.3%) with an age group of 22-31 years with female patients (219, 54.8%) reported more polypharmacy events. There were 216 patients (54%) with prescriptions of five medicines i.e., moderate polypharmacy. Total number of medicines consumed by all 400 patients was 2269, with a mean, SD 5.67, 1.08. Total expenditure by all 400 patients was USD 3409.54 during the study period, with a mean, SD 8.66, 6.04. Both moderate and severe polypharmacy cases were non-significantly related with age, gender and total cost of medications. They had significant relationship in almost all levels of education and occupation and showed mixed type of significance and non-significance with the diagnosis of the respondents. Conclusion: Polypharmacy cases can be minimized, considering adverse drug reactions and drug interactions. Further studies are warranted in medication utilization and avoidable polypharmacy along with detailed pharmacoeconomic evaluation.

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Determinants of Sports Injury in Young Female Swedish Competitive Figure Skaters

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.686019 ◽

2021 ◽

Vol 3 ◽

Author(s):

Moa Jederström ◽

Sara Agnafors ◽

Christina Ekegren ◽

Kristina Fagher ◽

Håkan Gauffin ◽

...

Keyword(s):

Outcome Measure ◽

Sports Injury ◽

Young Female ◽

Older Age ◽

Point Prevalence ◽

Severe Injury ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Multiple Model ◽

Figure Skaters

Introduction: Although figure skating attracts several hundred thousand participants worldwide, there is little knowledge about physical health and sports injuries among young skaters. The present study aimed to describe the health status of a geographically defined Swedish population of licensed competitive figure skaters and to examine injury determinants.Methods: All licensed competitive skaters in the southeastern region of Sweden were in April 2019 invited to participate in a cross-sectional study using an online questionnaire. Multiple binary logistic regression was used for the examination of injury determinants. The primary outcome measure was the 1-year prevalence of a severe sports injury episode (time loss >21 days). The secondary outcome measure was the point prevalence of an ongoing injury. The determinants analyzed were age, skating level, relative energy deficiency indicators, and training habits.Results: In total, 142 (36%) skaters participated, 137 (96%) girls [mean (SD) age: 12.9 (SD 3.0) years]. Participating boys (n = 5) were excluded from further analysis. The 1-year prevalence of a severe sports injury episode was 31%. The most common injury locations for these injuries were the knee (25%), ankle (20%), and hip/groin (15%). In the multiple model, having sustained a severe injury episode was associated with older age (OR 1.2, 95% CI 1.1–1.4; p = 0.002) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.014). The point prevalence of an ongoing injury episode was 19%. The most common locations were the knee (24%), ankle (24%), and foot (24%). Having an ongoing injury episode was associated with older age (OR 1.4, 95% CI 1.2–1.7; p < 0.001) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.049).Conclusion: One-third of young female Swedish competitive figure skaters had sustained a severe injury episode during the past year, and a fifth reported an ongoing episode. Older age and an increased number of skipped meals per week were associated with a sports injury episode. Long-term monotonous physical loads with increasing intensity and insufficient energy intake appear to predispose for injury in young female figure skaters. Further examination of injury determinants among competitive figure skaters is highly warranted.

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The importance of perioperative optimisation to facilitate safe regional anaesthesia and their improved outcomes in fracture neck of femur patients

Journal of Perioperative Practice ◽

10.1177/17504589211064042 ◽

2021 ◽

pp. 175045892110640

Author(s):

Benjamin Thomas Vincent Gowers ◽

Michael Sean Greenhalgh ◽

Kathryn Dyson ◽

Karthikeyan P Iyengar ◽

Vijay K Jain ◽

...

Keyword(s):

Hip Fracture ◽

General Anaesthesia ◽

Regional Anaesthesia ◽

Outcome Measure ◽

Secondary Outcome ◽

General Anaesthetic ◽

Secondary Outcome Measure ◽

Neck Of Femur ◽

One Year ◽

To Receive

Background: Hip fractures are common presentations to orthopaedic departments, and their surgical management often results in blood transfusions. Compared with general anaesthesia, regional anaesthesia reduces the need for transfusions and mortality in the wider surgical population. Aims: In hip fracture patients, our primary outcome measure was to examine any relationship between anaesthetic modality and transfusion rates. The secondary outcome measure was to assess the relationship between anaesthetic modality and one-year mortality. Methods: A retrospective cohort study of 280 patients was carried out in 2017 and 2018. Data were collected from patient records, local transfusion laboratory and the national hip fracture database. Results: A total of 59.6% had regional and 40.4% general anaesthesia. Regional anaesthesia patients were younger with fewer comorbidities (p < .05). About 19.8% regional and 34.5% general anaesthesia patients received transfusions (odds ratio (OR) = 0.47, p < .05); 13.6% were taking anticoagulants and were less likely to receive a regional anaesthetic (31.6% versus 64%, OR = 0.26, p < .05). One-year mortality was 27% for regional and 37% for general anaesthetic patients (OR = 0.64, p = .09). Conclusion: Regional anaesthesia halved the risk of blood transfusion. Anticoagulated patients were 74% less likely to receive regional anaesthetics, but had no additional transfusion risk. With optimisation, a larger proportion of patients could have regional anaesthesia.

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Knowledge and perception of Sepsis among Doctors in Karachi Pakistan

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.38.icon-2022.5775 ◽

2021 ◽

Vol 38 (ICON-2022) ◽

Author(s):

Faiza Ahmed ◽

Lubna Abbasi ◽

Fivzia Herekar ◽

Ahsun Jiwani ◽

Muhammad Junaid Patel

Keyword(s):

Critical Care ◽

Work Experience ◽

Cross Sectional Study ◽

P Value ◽

Common Belief ◽

Cross Sectional ◽

Health Networks ◽

Creative Commons ◽

Adequate Knowledge ◽

Open Access Article

Objectives: To assess knowledge and perception among Pakistani physicians towards sepsis. Methods: This cross-sectional study was conducted in Indus Hospital and Health Networks from September 2020 to March 2021. The International Sepsis Survey questionnaire was adapted, and its link was sent to trainee physicians as well as specialists, and consultants practicing in various hospitals via social media. Knowledge and perception were scored and 50% was considered the cut-off score for adequacy. Data was analyzed using SPSS version 26. Results: Analysis was done on 222 respondents who completed the survey. 37.9% of the participants had adequate knowledge. Knowledge regarding sepsis was significantly associated with specialty, ICU/CCU/HDU, and work experience (P-value <0.0001). More recent trainee physicians and those with more experience in critical care areas demonstrated better knowledge. Over 2/3rd of the respondents strongly agreed that sepsis remains one of the unmet needs in critical care today. Conclusion: A common belief exists that sepsis remains a challenge to treat among doctors. Moreover, there is consensus that it is the most frequently miss diagnosed condition in critical care and a dire need exists for its early diagnosis. Additionally, prompt management of presumed sepsis is imperative to improve outcomes. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5775 How to cite this:Ahmed F, Abbasi L, Herekar F, Jiwani A, Patel MJ. Knowledge and perception of Sepsis among Doctors in Karachi Pakistan. Pak J Med Sci. 2022;38(2):380-386. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5775 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Impact of blood group on survival following critical illness: a single-centre retrospective observational study

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2019-000426 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000426

Author(s):

Robert Slade ◽

Raza Alikhan ◽

Matt P Wise ◽

Lam Germain ◽

Simon Stanworth ◽

...

Keyword(s):

Intensive Care ◽

Critical Illness ◽

Blood Group ◽

Outcome Measure ◽

Tertiary Hospital ◽

Current Data ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Transfusion Requirements ◽

Significant Difference

BackgroundPredicting patient outcomes following critical illness is challenging. Recent evidence has suggested that patients with blood group AB are more likely to survive following major cardiac surgery, and this is associated with a reduced number of blood transfusions. However, there are no current data to indicate whether a patient’s blood group affects general intensive care outcomes.ObjectiveThe objective of this study was to determine if ABO blood group affects survival in intensive care. The primary outcome measure was 90-day mortality with a secondary outcome measure of the percentage of patients receiving a blood transfusion.DesignRetrospective analysis of electronically collected intensive care data, blood group and transfusion data.SettingGeneral intensive care unit (ICU) of a major tertiary hospital with both medical and surgical patients.PatientsAll patients admitted to ICU between 2006 and 2016 who had blood group data available.InterventionNone.Measurements and main results7340 patients were included in the study, blood group AB accounted for 3% (221), A 41% (3008), B 10.6% (775) and O 45.4% (3336). These values are similar to UK averages. Baseline characteristics between the groups were similar. Blood group AB had the greatest survival benefit (blood group AB 90-day survival estimate 76.75, 95% CI 72.89 to 80.61 with the overall estimate 72.07, 95% CI 71.31 to 72.82) (log-rank χ2 16.128, p=0.001). Transfusion requirements were similar in all groups with no significant difference between the percentages of patients transfused (AB 23.1%, A 21.5%, B 18.7%, O 19.9%, Pearson χ2 5.060 p=0.167).ConclusionAlthough this is primarily a hypothesis generating study, intensive care patients with blood group AB appeared to have a higher 90-day survival compared with other blood groups. There was no correlation between blood group and percentage of patients receiving transfusion.

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