Category: Articles

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Review Articles

Do medical students practice what they preach? A review of their dietary patterns over the last decade.

Abstract

Background

While many studies have been performed to evaluate different indicators of psychological distress among medical students, the amount of published data evaluating their dietary habits is limited. Therefore, the purpose of this scoping review was to provide an overview of medical students’ dietary behavior. This is the first review paper to summarise the information available about dietary practices among medical students.

Materials and Methods

A scoping review was performed in 2018 using the PRISMA-ScR framework and the MEDLINE database was searched by combining the terms ‘eat’, ‘diet’, ‘meals’, ‘nutrition’ with the word ‘medical student’ by using the ‘AND’ function. Some additional papers were also selected from the citations of relevant publications. Data was independently extracted by two authors using pretested forms.

Results

A total of 739 articles were found by using the search terms. Thirty-three articles fulfilled the eligibility criteria and four further articles were found from the citations of relevant publications. Medical students showed an increasing tendency to exhibit conventionally unhealthy eating patterns, both as a whole and within different dietary categories. In particular, decreased fruit and vegetable intake, overindulgence of fast food, and a tendency to skip meals. Gender discrepancies were also noted in some categories.

Conclusion

Medical students, while for the most part displaying a full understanding of the nutritional science behind dietary recommendations, did not always meet the advised levels for most of the categories explored. Lapses in personal dietary choices may affect patient counselling, in addition to the many direct consequences of improper nutrition on the health and wellbeing of the student themselves.

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Articles COVID COVID

Where in the world is the COVID-19 Vaccine?

The following article explores the novel coronavirus SARS-CoV-2, the global race to develop a vaccine and the many challenges faced by researchers during this unprecedented time. With a focus on the eight most promising vaccine candidates currently in clinical evaluation around the world, the results from the early stages of human trials are discussed and the difficulties faced by those at the forefront are brought to light.

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Letters COVID COVID

Medicine in the age of COVID-19 considerations for the ongoing use and development of telehealth

COVID-19 has necessitated rapid adoption of telehealth. The evidence for telehealth, however, is inconclusive at best. Further studies are required before it sees more widespread use.   

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Categories
Case Reports

A case of postoperative pericardial effusion progressing to tamponade

Introduction: Pericardial effusions often occur after cardiac surgery, usually asymptomatically. However, large postoperative effusions may cause cardiac tamponade, which is a medical emergency. Case overview: We report a case of a 62-year-old businessman who presented with worsening paroxysmal nocturnal dyspnoea, orthopnoea, and an episode of near-syncope. Echocardiography revealed evidence of cardiac tamponade, most likely due to recent coronary artery bypass graft and aortic valve replacement surgery. He was treated with pericardiocentesis and ongoing review revealed no recurrence of the effusion. Discussion overview: We discuss the incidence and risk factors for postoperative pericardial effusion and the possibility of tamponade after cardiac surgery. Though rare, recognising tamponade after cardiac surgery is vital and a thorough understanding of the treatment of tamponade is necessary.

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Case Reports

Aicardi-Goutières Syndrome: A Case Report

Background: Aicardi-Goutières Syndrome (AGS) is a rare genetic neurological disorder that presents as pseudo-TORCH syndrome. There are 350 confirmed cases worldwide. This case report describes a 22-month-old male with Aicardi-Goutières Syndrome who was diagnosed at four months of age. This paper seeks to highlight AGS as a differential for TORCH Syndrome, and to build on the limited knowledge from previous cases to identify key concepts and management strategies that may be of benefit to the medical community.

Case overview: A four-month-old male was admitted to a New Zealand Hospital in status epilepticus.A history of inconsolable crying, subjective fevers and abnormal posturing was elicited. Examination found a spastic quadriplegic cerebral palsy. Investigation excluded infective causes. MRI and CT scans demonstrated atrophy of the cerebral cortex with calcification of the basal ganglia. CSF analysis showed elevated white cells and neopterin, and genetic analysis identified variants of unknown significance in the ADAR1 gene. A diagnosis of AGS was made. Treatment focused on managing complications including seizures, spasticity, and airway clearance.

Discussion overview: This case highlights AGS as a differential for TORCH syndrome. Complication management forms the basis of care. Current literature is limited, and future research is needed to understand the pathophysiology of the disease to develop treatments and management strategies.

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Categories
Letters COVID COVID

How COVID-19 has changed My Medical Experience

An expression piece on the personal impact of COVID-19 on my travel home (to Sri Lanka), personal life, studies and clinical placement.

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Letters COVID COVID

The impact of COVID-19 on the mental health of medical students in Australia

COVID-19 has left an overwhelming impact on medical students through the miscommunication of directives. It has resulted in many students feeling confused, dejected and exhausted.

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Categories
Uncategorized Review Articles

Musculoskeletal Disorders in Surgeons

Background

Musculoskeletal disorders (MSDs) are an occupational hazard amongst surgeons, causing detrimental effects in up to 20% of surgeons in their lifetime. However, there is a paucity of data examining solutions for the problem. There is also a lack of research comparing MSDs in surgeons who perform open surgery compared with those who perform newer methods of surgery such as laparoscopic and robotic surgery.

Aims

We aim to explore existing literature about the various risk factors and the consequences of MSDs. We believe that by raising awareness of such risk factors to medical students from early on in their medical careers, they can develop an appreciation of the potential long-term impacts and take an early approach to prevention. We discuss preventative strategies in the categories of individual, occupational, institutional, and intra-operative techniques.

Materials and Methods

Ovid Medline, Cochrane Library, and PubMed databases were used to identify articles. Studies reporting on work-related MSDs in surgeons were included. Articles relevant to medical fields with a high level of surgical involvement, such as gynaecology, were also included. This information was used to construct a narrative review of the literature (see Appendix 1 for full methodology). Within each database search, only a few articles relevant to this review were generated. Therefore, the citations were also screened to find additional articles that fit within the scope of this review.

Results

Multiple factors were found to contribute to the development of MSDs, including individual and occupational factors. MSDs have resulted in a high percentage of surgeons performing fewer surgeries or taking more time off work. Similar risk factors applied to laparoscopic and robotic surgery. Few studies examined strategies to combat MSDs, but techniques such as intraoperative exercise and ergonomic training have shown to be promising.

Conclusion

There is a need for ongoing research into strategies to prevent MSDs in surgeons. Currently there are no evidence-based guidelines for management of work-related MSDs. Medical students should be aware that this occupational hazard has deleterious effects on the body and should be encouraged to employ some of the currently available strategies to prevent MSDs. The authors of this review advocate for ergonomics education to be integrated into surgical training programs via collaboration between ergonomists and surgical program directors.

Main Learning Points

  1. MSDs in surgeons are under-researched but are still an important occupational hazard that can be potentially debilitating.
  2. There are no guidelines to manage MSDs – current best strategies involve having a well-balanced lifestyle, seeking help early, and being ergonomically aware of mechanisms of injury.
  3. Greater awareness of ergonomics among surgeons could possibly reduce the incidence of MSDs among high risk groups.

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Categories
Case Reports

A multidisciplinary approach in diagnosing children with autistic traits and multiple behavioural issues: a case report

diagnosing children with autism
diagnosing children with autism

The diagnosis of Autism Spectrum Disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria is based on a constellation of symptoms overarching social and communication deficits, behavioural issues, and stereotyped motor and sensory abnormalities. Some studies have raised concerns about overdiagnosis and misdiagnosis of ASD, likely due to the overlapping symptoms of ASD and other psychological and behavioural disorders. This case emphasises the importance of an integrated multidisciplinary diagnostic approach for ASD diagnosis as a single consultation is usually insufficient for paediatricians to reach to the conclusion of ASD. With valuable inputs from different disciplines, including psychology and speech therapy, paediatricians can have a better picture of a child’s underlying issues and provide a more effective management plan for the family. 

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Categories
Original Research Articles

Welcome to the wards: Pilot study on microbial contamination of medical students during initial clinical rotations

Background: Pathogenic bacteria can colonise the hands, medical equipment, and personal belongings of healthcare workers (HCW) exposed to clinical environments. Healthcare-associated infections (HAI) arising from the transmission of these pathogens to patients causes morbidity, mortality, and an economic burden. Despite widespread healthcare worker education and policy change, the incidence of HAI remains high in Australia.

Aim: To identify potentially pathogenic bacterial contamination of clinically unexposed medical students’ hands and items upon entry into the clinical environment and subsequent design of a definitive study.

Materials and methods: A pilot prospective cohort study was performed at a large tertiary hospital in Melbourne, Victoria. Eight medical students had two- to six-week samples taken from their dominant hand, mobile phones, and stethoscopes in the first six months of entering the clinical environment.

Results: Pathogenic bacteria were detected throughout the six-month testing period on five of the eight students’ hands, mobile phones, or stethoscopes. Pathogenic bacteria grown included methicillin-sensitive Staphylococcus aureus, Enterococcus faecalis, and Gram-negative pathogens, such as Serratia marcescens, Pseudomonas spp. and Acinetobacter baumanii. No multi-resistant organisms were detected. Low decontamination rates of items, universal use of phones while on the toilet, and recent hand hygiene credentialing were reported by participants.

Conclusion: Colonisation by nosocomial pathogens on medical students’ hands, mobile phones, and stethoscopes was identified during the first six months of clinical study. Further research to characterise bacterial contamination of new HCW, risk factors, and strategies to improve infection control practices has the potential to reduce HAI.

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