Prevalence of bronchial asthma in Indian children

BACKGROUND: The prevalence of childhood bronchial asthma and allergic disease has increased in developed countries. Studies have identified asthma among Indian children. Still, there is paucity of information on the overall prevalence of childhood asthma in India. OBJECTIVE: To assess time trends and the overall prevalence rate of bronchial asthma among Indian children. MATERIALS AND METHODS: Literature search for data sources was done through an extensive search in indexed literatures and website-based population survey reports. Fifteen epidemiological studies were identified on the development of asthma in Indian children from 300 potentially relevant articles. A broad criterion to define both allergic and non-allergic descriptions of asthma in Indian children was formed. Moreover, in the absence of universally accepted criteria by reporting of prevalence by researchers, weighted average data was considered during calculations of prevalence rates, irrespective of the criteria for diagnosis. Statistical analyses used were mean and median. RESULTS: Wide differences in samples, primary outcome variables, lack of consistency in age category, rural–urban variation, criteria for positive diagnosis, and study instruments confounded the outcome variables. The mean prevalence was 7.24 ± SD 5.42. The median prevalence was 4.75% [with IQR = 2.65 − 12.35%]. Overall weighted mean prevalence was found to be 2.74. Childhood asthma among children 13 – 14 years of age was lower than the younger children (6 – 7 years of age). Urban and male predominance with wide inter-regional variation in prevalence was observed. CONCLUSIONS: Our findings indicate that the burden of bronchial asthma in Indian children is higher than was previously understood

Pain management: An ignored medical issue

Background: Pain is reality from womb to tomb as the specific personalized articulated feeling of human beings whether they need respite or not. Objective: To find an optimum primary care approach to pain management. Methods: The investigators pursued a sincere effort to unearth an answer to pain management through their internalized clinical experience of managing the commonest presentation of symptoms at their clinics by hundreds of ailing citizens. Results: Since ancient times, thousands of interventions have been practiced for relief of pain including an array of self-medications and traditional practices. In the era of "Evidence Based Medicine" in this new millennium, all forms of pain managements need scientific evaluation by the application of highest research integrity before they can be adapted as a standard treatment protocol. As the severity of the pain is a grossly subjective, the treatment/drug of choice and/or the methods/dosage should depend on the judgments of objective severity by the health care providers, depending on the objective clinical/ radiological/ pathological/ biochemical criteria and if possible by formulating scoring systems. Rather than managing the pain based on the expressed perception of the severity of pain by the patient as mild, moderate or severe, we have to be innovative in the new paradigm of this nascent pain management scenario. Conclusions: We have to help the budding doctors to grow up not only as a sensible doctor, but also as a great human being, who will give due attention to pain through a holistic tailor-made approach

Medical Education: The Hot Seat

Medical science has eventually metamorphosed from ′Knowledge based′ to ′Skill based′ applied social science. So, the age-old traditional courses and curriculums in Indian medical education need a overhauling with radical modifications. With a paradigm shift, we have to take into account not only the help of scientific feedback from the teachers and students but also from all the stakeholders of health care delivery system

Assessment of impact of small group teaching among students in community medicine

Background: We conducted a study to assess the impact of small group teaching (SGT) among students by feedback analysis to identify intricacy so that learning can be facilitated. Materials and Methods: This cross-sectional study was undertaken among 182 MBBS students studying at a teaching hospital at Gangtok. Students were provided with a questionnaire following an assignment on a scheduled topic. Students were asked to provide feedback on the modes of teaching-learning practiced in community medicine with the parameters of evaluation including assessment of presentation by faculty member in reference to relevance, sequencing, depth, interaction, etc., to the overall rating of presentations in different teaching-learning methods. Results: The faculty members were on the positive evaluation by the students in the SGT, which was preferred over "lectures" as the teaching-learning methods. Among SGTs "tutorials" were graded better than "practical," "seminar" and "field posting" on the basis of longer duration at a stretch. Among the parameters for evaluation, relevance, depth, and interaction in regard to scheduled topic of presentations, the rating was significantly higher in SGT than different other teaching-learning methods. Largely the students noted that the time devoted and number of hours/sessions allotted for each topic was adequate. Conclusion: All forms of SGT were on the positive appraisal by the students on their learning experience and were considered as a comprehensive tool for in-depth teacher-student interaction