Body volume is the major determinant of worsening renal function in acutely decompensated heart failure with reduced left ventricular ejection fraction
Conclusions
Normal body volume and lower serum BNP on admission were associated with worsening of renal function in patients with HFrEF hospitalised for ADHF. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Ho, M. H., Huang, D., Ho, C.-W., Zuo, M.-L., Luo, A.-G., Cheung, E., Zhou, M., Cheng, Y., Liu, M., Yiu, K.-H., Lau, C. P., Yeung, P., Yue, W. S., Yin, L.-X., Tse, H. F., Jiang, W., Lei, Z., Li, X.-L., Cowie, M., Siu, C. W. Tags: Editor's choice Original research Source Type: research
Unexpected high HbA1c results due to an unusual haemoglobin variant: an important clinical lesson
Introduction The measurement of glycated haemoglobin (Hb), reported as HbA1c, is recommended for the screening, diagnosis and monitoring of diabetes mellitus. HbA1c measurement usually provides an assessment of an individual’s glycaemic control over the previous 2–3 months and correlates with the development of diabetic complications. Standardisation of results attempts to ensure both intra- and inter-assay agreement so that an individual’s glycaemic control can be accurately monitored. Historically, standardisation was performed based on the Diabetes Control Complications Trial (HbA1c reported as a perce...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Floyd, C. N., Brady, S., Monteiro, D., Nathan, Y., Crook, M. Tags: Adverse drug reactions Source Type: research
Educational opportunities for postgraduate medical trainees during the COVID-19 pandemic: deriving value from old, new and emerging ways of learning
The COVID-19 pandemic has had a significant impact on postgraduate medical training across all specialties. Although some traditional learning opportunities have been curtailed, there have been numerous examples of highly valuable educational experiences that have arisen during this time. Here, from a trainee perspective, we consider the educational merits of the re-emergence of ‘firm-based’ teams, new online learning opportunities, use of digital technologies and the rise of telephone clinics and new COVID-19 clinical services. As health services continue to recover from surges in COVID-19 cases, it is importa...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Kumar, K., Groom, K., Martin, L., Russell, G. K., Elkin, S. L. Tags: Open access, COVID-19 Education and learning Source Type: research
Medical education challenges and innovations during COVID-19 pandemic
COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. The new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the ‘acting up’ of medical students a...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Papapanou, M., Routsi, E., Tsamakis, K., Fotis, L., Marinos, G., Lidoriki, I., Karamanou, M., Papaioannou, T. G., Tsiptsios, D., Smyrnis, N., Rizos, E., Schizas, D. Tags: COVID-19 Education and learning Source Type: research
Preprint: already the bride or still the bridesmaid?
Preprint, as the term is self-explanatory, is the final draft of a research paper that is digitally shared openly before being certified by peer-review. The long and tedious process of publishing a scientific paper coupled with researchers’ desire to stake their claim as publishing first in the field to protect their intellectual property rights has led to the increasing popularity of preprints. A preprint allows them to quickly and publicly share their research online; get a digital object identifier (DOI) number; retain the copyright and get online feedback from peers to improve the manuscript before submitting it ...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Vaish, A., Sharma, D., Vaishya, R. Tags: Editorials Source Type: research
Fake COVID-19 vaccinations in Africa
Deliveries of vaccine supplies by the COVAX programme under the WHO commenced in February 2021.1 COVAX has proposed to distribute 520 million doses to Africa by the end of 2021.1 On 28 March 2021, African Union member states endorsed purchasing 220 million doses of the Johnson & Johnson single shot of the COVID-19 vaccine. However, priority was given to the Johnson & Johnson vaccine to the central-most pooled procurement due to being a single-shot vaccine, being cheap and easy to administer, having good storage conditions and production of doses being within Africa, with fill–finish activities taking place in...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Aborode, A. T., Awuah, W. A., Talukder, S., Oyeyemi, A. A., Nansubuga, E. P., Machai, P., Tillewein, H., Oko, C. I. Tags: COVID-19 Editorials Source Type: research
All research contributions are equal: some more so than others
Rahnejat, Okhiria and Webster propose in a recent article that the United Kingdom Foundation Programme Office (UKFPO) redesign the point-based system used to score foundation programme applicants.1 Their proposals centre on the allocation of points related for student involvement in published research. The authors seek to establish a hierarchy of published research such that some kinds of research and authorship (such as being first author, or the work being a randomised controlled trial (RCT)) are valued greater than others (letters to the editor—the present one included!) As a medical student who will soon be grapp...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Fisayo, T. Tags: Letter Source Type: research
AFP application rates: more than meets the eye
We would like to thank Donaldson et al for their study on whether the medical school attended by a student contributes to their chances of applying to and receiving an offer from the Academic Foundation Programme (AFP).1 They found that while there is no correlation between medical school rankings and AFP acceptance rates, students from research focused medical schools that mandate partaking in an intercalated degree (iBSc) are more likely to apply for the AFP. Donaldson et al suggested that this may be due to factors such as students’ awareness of the AFP, the volume of emphasis that each university places on applyi...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Ta Anyu, A., Lau Shu En, R., Lee, D. R. Tags: Letter Source Type: research
Acute painful calcific tendonitis of the shoulder
A 39-year-old woman with diabetes presented with a history of disabling pain in the right shoulder for 5 days. She had pain and stiffness for last 8 months, which did not respond to physiotherapy and NSAIDs. The shoulder movements were significantly restricted and painful. A radiograph revealed a large radio-opaque shadow under the acromion process (figure 1A), suggestive of calcific tendonitis. It was confirmed with MRI (figure 1B). Arthroscopic decompression of the calcific deposit (‘chalky paste’ like) was done (figure 2A–E). It gave instantaneous and dramatic pain relief. Calcific tendonitis occurs in...
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Vaishya, R., Vaish, A., Ansari, A. H. Tags: Images Source Type: research
Ainhum: revisited
Discussion Ainhum also called as dactylolysis spontanea is derived from the Nago (Brazil) word meaning fissure or Nigerian word meaning ‘to saw or cut’.1 It is a rare disease chiefly noticed among black Africans and African Americans with male predominance ratio of 2:1 with symmetrical distribution though isolated digits can also be affected.2 In adults, occurrence is idiopathic, but vascular hypoxia, mechanical trauma and recurrent... (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - April 21, 2022 Category: General Medicine Authors: Prarthana, M., Karthikeyan, K. Tags: Images Source Type: research
'An enemy of the people: doctors as scapegoats
One distressing aspect of the COVID-19 pandemic for some doctors and health scientists has been to find themselves the targets of hatred for carrying out their professional duties. This has been a particular problem for physicians in public health. Anthony Fauci, chief medical advisor to the US president, has been the focus of systematic attempts to vilify him with the label of ‘public enemy number one’ because of information and guidance he has issued.1 In England, two men have been convicted for a physical assault on the government’s chief medical officer, Sir Chris Whitty, for the same reason.2 Epidemi...
Source: Postgraduate Medical Journal - March 22, 2022 Category: General Medicine Authors: Launer, J. Tags: On reflection Source Type: research
Medical doctors in India are on strike: a moral and national conundrum
Health services across north New Delhi, the capital city of India, have come to a standstill over the last week, with doctors from Hindu Rao Hospital going on an indefinite hunger strike since 23 October 2020 amid a global health crisis due to COVID-191 in response to unpaid wages. Similar non-payment of salary for the last 16 months led Karnataka doctors to strike in July 2020. Strikes by medical doctors in India are not unknown but these seem to have become a moral and national problem. Increasing reports of violence against doctors, fear of being sued and inadequate security provided to doctors in hospitals have traditi...
Source: Postgraduate Medical Journal - March 22, 2022 Category: General Medicine Authors: Iyengar, K. P., Jain, V. K., Vaishya, R. Tags: Letter Source Type: research
'Master of many faces: extrapulmonary tuberculosis in the eyes of otolaryngologists
The articles published in August 2020 entitled ‘tuberculosis (TB) or not TB?’ and ‘sarcoidosis with multiorgan involvement’ under the ‘image’ section have particularly caught our attention. The unfortunate occurrence of misdiagnosis of patients with TB infection, which has transpired into different pathologies of non-identical entities, have evidently demonstrated the possibility of a heterogeneous spectrum of tuberculosis manifestation. In the practice of otolaryngology, the diagnosis of extrapulmonary TB (ETB) typically imposes challenges owing to its variable clinical presentation and...
Source: Postgraduate Medical Journal - March 22, 2022 Category: General Medicine Authors: Tuang, G. J., Muhammad, A., Zahedi, F. D. Tags: Letter Source Type: research
Letter to the Editor: Impact of enhanced personal protective equipment on the physical and mental well-being of healthcare workers during COVID-19
We read with great interest the study by Swaminathan et al, which aimed to determine the effect of personal protective equipment (PPE) on the physical and mental well-being of patient-facing staff during the COVID-19 pandemic.1 It has been widely evidenced that COVID-19 has a profound impact on an individual’s physical and mental well-being,2 yet it is unclear to what extent PPE is a contributing factor. While we agree that the authors have provided valuable insight into this matter, we have some questions related to the design and reporting of this study. The authors state that ‘the impact on mental well-being...
Source: Postgraduate Medical Journal - March 22, 2022 Category: General Medicine Authors: Super, J., Jeilani, M., McVeigh, J. Tags: COVID-19 Letter Source Type: research
Red carpet of filiform polyposis!
A 27-year-old man, already a diagnosed case of ulcerative colitis, on treatment with prednisolone, presented with bloody diarrhoea, rectal bleeding and severe anaemia for the last 2 months. There was no evidence of cytomegalovirus/clostridial/any other superimposed infection on biopsy or stool culture. The patient was in remission with corticosteroids for last 2 years. Subtotal colectomy was performed for steroid refractory ulcerative colitis. Gross examination revealed a diffuse carpet of closely packed slender, worm-like, polyps, >100 in number, ranging from 0.3 to 3 cm in length and 0.2–0.6 cm in diameter (figu...
Source: Postgraduate Medical Journal - March 22, 2022 Category: General Medicine Authors: Goyal, S., Sakhuja, P., Gupta, K., Saluja, S. Tags: Images Source Type: research
