Memchoubi P.,Regional Institute of Medical science |
Meera T.,Regional Institute of Medical science
Journal of Indian Academy of Forensic Medicine | Year: 2016
Any negligence of a medical practitioner, by an act of commission or omission, in performing his/her duty is known as medical negligence. Failure to exercise reasonable care and skill in the management of a case is a potential problem area with legal liabilities in medical practice. Autopsy is an efficient method of clarifying medical malpractice claims. In this paper, a report on a series of five mismanaged cases is presented. In this series, the case one was a post-caesarean case who died after the operative procedure. The case two and three were cases of uterine rupture. The case four was also a post-caesarean case who died because of bleeding and complications. The case five was a case of laparoscopic cholecystectomy and appendesectomy who died of haemorrhagic shock following the operative procedure. Lack of proper care and monitoring, failure to recognize the complications in time and failure to take prompt life saving measures like emergency surgical intervention have led to the fatal outcomes in these cases.
Singh L.R.,Regional Institute of Medical science |
Singh N.N.,Regional Institute of Medical science
Asian Pacific Journal of Cancer Prevention | Year: 2013
Background: Cancer of the uterine cervix is one of the most common cancers among women worldwide. Industrialized countries have dramatically reduced the incidence of mortality from cervical carcinoma in the last 50 years through aggressive screening programs utilizing pelvic examinations and Papanicolaou (Pap) smears but it still remains a major problem in the developing world. Objectives: This study was performed to determine knowledge, attitude and practice of Pap smear as a screening procedure among nurses in a tertiary hospital in north eastern India. Material and Methods: This cross sectional study was carried out with a questionnaire survey covering the socio demographic factors, knowledge, attitude and practices about Pap smear screening among 224 nurses in Regional Institute of Medical Sciences, Imphal, Manipur, India during December 2011. Results: Two hundred and twenty one participants (98.6%) had heard about cervical carcinoma but 18.3% lacked adequate knowledge regarding risk factors. Knowledge about the Pap smear was adequate in 88.8% of the respondents. Out of these, only 11.6% had Pap smear at least once previously. The most common reasons for non-participation in screening were lack of any symptoms (58.4%), lack of counselling (42.8%), physician does not request (29.9%) and fear of vaginal examination (20.5%). Conclusion: Although knowledge of Pap smear as a screening procedure for cervical cancer is high, practice is still low. The nurses who should be responsible for opportunistic screening of women they care for are not keen on getting screened themselves. If we can improve the practice of Pap smear screening in such experts, they should be able to readily provide appropriate and accurate information and motivate the general population to join screening programs.
Meera T.,Regional Institute of Medical science |
Bapin Kumar Singh M.,JLN Institute of Medical science
Journal of Indian Academy of Forensic Medicine | Year: 2011
Deaths due to hanging are common among suicides. In a study on 84 cases of suicidal hanging brought for autopsy to the mortuary of the Regional Institute of Medical Sciences, Imphal during 2004 to 2008, it was observed that 77.38% of the cases were males and 22.62% were females. The highest number of victims was in the age range of 21-40 years. 73.81% of the cases committed suicide indoors and 57.14% of them used ropes as ligature material. 85.75% of the victims had fixed knots with a single turn and 10.71% had slip knots. Complete atypical hanging constituted 88.10% of the cases. 23.81% of the cases had tear of the carotid artery and 3.57% had hyoid fractures. None of the cases had cricoid or trachea fractures. The neck findings vary depending upon the composition, multiplicity and tightness of the ligature material used, the suspension time, type of hanging, etc. Hence, the possible findings in a suspected case of hanging must be always anticipated so as to avoid any erroneous opinion.
Salam R.,Regional Institute of Medical science
JMS - Journal of Medical Society | Year: 2015
Patients with diabetes mellitus undergo surgery more frequently than non-diabetics. Diabetics tend to have increased morbidity and longer hospital stay following surgery, which may be due to higher risk of infection and co-morbidities such as cardiovascular complications and nephropathy. Studies have shown that pre-operative glycemic control have a significant impact on the risk of infections. Glycosylated hemoglobin below 7% is the usual pre-operative target, but values between 8% and 9% may be acceptable depending on individual circumstances. Recent guidelines from Australia and UK no longer recommend withdrawal of oral hypoglycemic agents including metformin before surgery. Cardiacrelated and overall mortality are greater with increased post-operative blood glucose levels. American Association of Clinical Endocrinologists and the American Diabetes Association recommends target glucose levels < 180 mg/dL in critically ill patients and < 140 mg/dL in non-critically ill patients. Insulin-glucose infusion is the preferred mode of insulin therapy until patient is able to take adequate calorie orally. Sliding scale insulin is no longer recommended and supplemental insulin protocol is more appropriate. Hypoglycemia is also a major contributor to an adverse outcome and severe hypoglycemia should be avoided. © 2014 Regional Institute of Medical Sciences. All rights reserved.
Moirangthem G.S.,Regional Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2014
Laparoscopic cholecystectomy, being already declared as gold standard technique, laparoscopic surgery has advanced far and wide, touching almost every corner of the abdomen. This advancement has gradually expanded to colorectal surgery which is done for malignant diseases as well. However, laparoscopic colorectal surgery has not been accepted as quickly as was laparoscopic cholecystectomy. This is because of its steep learning curve, concerns with oncological outcomes, lack of randomized control trials (RCTs) and initial reports on high port site recurrences which occurred after curative resections. But all these initial concerns have been overcome by doing a series of RCTs globally, in the past decade, that revealed that laparoscopic colorectal surgery for malignant disease offered short term benefits without compromising on oncological principles of radicality of resection, tumour resection margins and completeness of lymph node harvesting as compared to those of open surgery. Favourable post-operative results with respect to less blood loss, less pain, lesser surgical site infections, lesser requirement of analgesics, early return of bowel function and shorter hospital stay in patients who underwent laparoscopic colorectal resections were obtained in studies done on individual series, including those done in India and more recently, in large trials. An update on recent studies done on laparoscopic colorectal surgery by reviewing many RCTs and individual series, including our experiences, was made, to support the advantages of this procedure which were obtained when it was carried out by skilled hands.
Ranabir S.,Regional Institute of Medical science
Indian Journal of Endocrinology and Metabolism | Year: 2015
Type 1 diabetes mellitus is a challenging situation for both physician and patient, as it requires a very disciplined lifestyle with regular monitoring and follow-up. It becomes even more difficult when facilities are limited. Manipur has a difficult terrain and due to lack of adequate facilities patients face frequent hypoglycemic episodes and hyperglycemic crises. Continuous availability of insulin is not possible at all times. The health care workers in the state are not fully aware of right practices and incorrect injection sites and erroneous techniques are also quite prevalent. Some quacks and traditional healers claim that they can cure diabetes by their indigenous preparation.
Ragui S.,Regional Institute of Medical science
Journal of Indian Academy of Forensic Medicine | Year: 2015
The present study aims to determine the age of the Manipuri population by computing regression formulae from the eruption of the permanent canine & second molar, and also from the epiphyseal union at the elbow and wrist joints. 320 Manipuri subjects of 10 to 15 years (i.e. 244 male, 76 female) coming to the Forensic Medicine department of a tertiary health care hospital at Imphal for age determination from October 2011 to September 2013 were studied. The age of eruption of permanent canines is 10 years in both sexes; whereas the eruption of second permanent molar is 11-12 years in females and 11-14 years in males in the Manipuri population. The medial epicondyle fuses with the shaft of humerus in 11-14 years in both the sexes. The epiphyseal fusions of 1st metacarpal take place in 13 -15 years in females and 12-14 years in males. A combined regression formula was calculated for males and females. It can be used as a standard for determination of age in Manipuri subjects by substituting the various stages of dental eruption or epiphyseal union.
Memchoubi P.,Regional Institute of Medical science
Journal of Indian Academy of Forensic Medicine | Year: 2015
A retrospective study of the road traffic accident cases starting from July 2009 to June 2014 was done. The aim was to find out those cases where fatal internal injury occurred without visible or significant external trauma. 84 cases out of 362 cases were selected. These cases were analysed regarding parameters like age and sex of the victim, the type of vehicle involved, manner of production, period of survival, type of road, cause of death, wearing apparel of the victim and relationship between visible external and internal injuries. In all these cases, a fatal internal injury was present in the absence of corresponding external injury. Therefore, it is suggested that absence of visible external injury should not be taken lightly as it may be associated with a fatal wound inside. The first 6 hrs turned out to be the most crucial. Head should be properly investigated for any injury as this has turned out to be the most vulnerable part. Nevertheless, a complete bodily investigation is a must to avoid any unwanted incident as well as a safeguard from allegations of medical negligence.
Sharma A.B.,Regional Institute of Medical science
Bangladesh Journal of Medical Science | Year: 2014
Objective: To review the demographic, clinical and histomorphological aspects of xanthogranulomatous inflammation (XGI) in different organs. Material and methods: All the cases diagnosed as XGI by histopathology from the specimens received in the department of Pathology, Regional Institute of Medical Sciences, Imphal, Manipur, India over the period of 10 years from January 2001 to December 2010 were included in the study. All the available data including age, sex, organ of involvement, association with stone etc. were collected and analyzed retrospectively. All the slides were reviewed. The results were recorded and ana-lyzed. Results: A total of 98 cases of XGI were diagnosed out of a total of 9755 specimens received, constituted by 5382 of gall bladder, 4298 of appendix, 41 of kidney and 24 of tube and tubo-ovarian mass making an overall incidence of 1%. The incidence of XGI in kidney was 12.19%, followed by 4.16% in tube and tubo-ovarian mass, 1.5% in gall bladder and 0.25% in appendix. Maximum number of cases were in the age group of 41-50 years with 33.67%. The female to male sex ratio was 2.5: 1. 90.2% cases in kidney and 86.6 % in gall bladder were associated with calculi. One case was associated with adenocarcinoma of gall bladder. Conclusion: Xanthogranulomatous inflammation which often mimics malignancy clinically and morphologically, is increasingly recognized in different anatomic locations. An accurate diagnosis will relieve the psychological panic of suspected malignancy and prevent the patient from aggressive treatment.
Phurailatpam J.,Regional Institute of Medical science
JMS - Journal of Medical Society | Year: 2016
Background: Students consider physiology as a dry, difficult, and vast discipline to be mastered in too short period. Small group tutorials (SGTs) per se are “extra efforts” in the curriculum, conducted every week for assessing the effectiveness of lectures on knowledge delivery, and in part, a formative assessment for the student. At present, tutorials consume a considerable 60 h in an academic term which may be utilized otherwise for the students, if not beneficial. Aims: To highlight the perspective of undergraduate students with special regards to SGTs and to identify modifiable/ amendable areas, if any in the current form of SGTs, which may likely improve teaching‑learning process of physiology in a North Eastern Medical Institute, Imphal. Materials and Methods: Anonymous feedback questionnaires from 95 students in 1st year MBBS were obtained after exposure to existing tutorials in physiology and analyzed accordingly. Results and Conclusions: Students perceive the present form of the tutorial as one that benefits them in many positive ways in improving their understanding and knowledge of physiology. However, insufficient interaction time as well as tutor’s attitude during tutorials attracted negative responses. They expressed strongly against the tendency of the teachers to re‑enforce the importance of memorization as the ultimate way to learn and 95% of them wanted more tutorials as they found that it drives them toward more study covering more topics which increase their self‑confidence and can assess their own level of knowledge so that they can improvise accordingly in time. © 2016 Journal of Medical Society.