Introduction: A number of studies on military and civil parachuting injuries have been published in the past. Most of the studies place the incidence of parachuting injuries to vary between 0.22% and 0.89%. The profile of injuries sustained during jumps by Indian paratroopers from Paratrooper Training School (PTS), Agra, between 2013 and 2019 was analyzed. Material and Methods: A retrospective analysis of Indian military parachuting injuries was done to assess injury patterns from the records of static line and combat free fall jumps, available at the PTS. The data pertaining to 270 injuries sustained from 256 jumps were analyzed in terms of number of jumps by each paratrooper, type of course/ mission, age, time of the of jump (day/ night), type of parachute used, wind speed at the time of drop, terrain on which the paratrooper landed, the location / part of body injured, the diagnosis, and finally the possible modality of injury using descriptive statistics. Results: The incidence of injuries ascertained from the records varied from 0.054% to 0.10% with a mean incidence of 0.083% from 306,986 jumps recorded over 7 years. Most injuries were related to refresher jumps and static line jumps. There were three fatalities recorded in this period, all due to failure of main and standby parachutes. Most of the injuries were sustained at the time of landing (218, 86.17%). Lower limb injuries accounted for maximum injuries (109, 40.37%), followed by truncal injuries 95 (35.19%) and upper limb injuries 33 (12.22%). Conclusion: The study brings out an interesting aspect of significantly less military parachuting injuries seen in the present study vis-à-vis reported in literature. A high degree of physical fitness and rigorous training are probably responsible for this low incidence. Increasing the duration of refresher training and physical conditioning may further reduce the occurrence of injuries. A cost-efficacy analysis of the same may be done before effecting changes in the training programme.
Introduction COVISHIELD and COVAXIN have been introduced post rapid approval as COVID vaccines in India, which has the second most COVID cases across countries. These vaccines are being administered in a two-dose schedule from 16 Jan 2021. This study deals with the clinical profile of individuals who developed COVID infection post-COVID vaccination. This is the first study of similar nature in India. Methodology The study population comprised of individuals who were detected to be COVID positive 04 weeks post-vaccination and were compared with individuals detected positive within the first 04 weeks of vaccination. Data was collected in a digital questionnaire format and analyzed with SPSS v-23 software. Clinical features were profiled in detail. Chi-square analysis was done to find out the association of various demographic features with the severity of the disease. Results In the study population, fever was the commonest symptom (75.1%) followed by anosmia (72.1%), and shortness of breath (16.3%). There was a lower incidence of fever, cough, dyspnea, and requirement of hospitalization in the study population as compared to the control group and previous epidemiological data. The time required for complete recovery and disease severity was favorable in our study population. There was a significant correlation in the rate of hospitalization among the study group and the comparative group (p=0.0001) and between the number of dosage of COVID vaccine with the lowest SpO2 recorded (p=0.001). Conclusion This study will boost the ongoing initiative of having a maximal vaccinated population countrywide and emphasize the need for two doses of vaccination.
The Students’ Scientific Society at the Armed Forces Medical College was set up to inculcate a scientific temper among medical students. For many years the main focus of the society was on conducting medical symposia.It was only in 2005 that under-graduate medical research received a fillip when the Young Researchers Forum was started. This was an annual event to showcase the students’ research work. Over the years, this forum has metamorphosed into one of India’s largest under-graduate medical conferences, namely, Illuminati. Since the college has been in the forefront of promoting UG medical research, there was a thought that we should take it a step further. A scientific journal to showcase their research was considered to be the next logical venture. “Praxis”is the result. This term has its origin from the Greek word “prassein” for ‘to do’. The dictionary meaning of praxis is ‘exercise or practice of an art, science or skill’ or as ‘practise as distin-guished from theory’. The Roget’s thesaurus describes it as ‘effectuation’ or implementing an idea into action or a hard theory into practise. All definitions have two terms in common and they are knowledge and practise. The two are sequential and the latter cannot come without the former. Today, praxis is required for both acquiring knowledge and practical skills. Technology has changed the process of knowledge acquisition. It is now available at the click of a button, and on your palmtop. This being so, the quantum of information ac-cessed and assimilated has also become byte-sized. The answer to a query posed is available by just accessing the appropriate search engine on the internet and typing the right key-words. The information is available in a jiffy and everywhere and whenever you want it. Trips to the library, and rifling through musty journals and ponderous note-takings are things of the past. This democratisation of knowledge has had one big fallout. The praxis of reading a full book or article has fallen by the wayside. The joy of doing so was in discovering how a scien-tist put forth his theory, presented facts and argued logically to prove his point. The apprecia-tion of the thought process is still critical for scientific reasoning. So the first challenge that teachers of medicine face today, is to get students back to reading books and monographs and not rely solely on wikipedia for medical information. Truncated attention spans and multi-ple distractions posed by information overdose on the internet will be barriers to this change. Medical textbooks will have to be rewritten to make them more readable and engaging. I was reading a retelling of the Mahabharatha a few years ago and was amused to note that the author had thoughtfully provided bulleted points at the end of each chapter. This may be the writing on the wall for us to follow. The other challenge in medical education today is making our graduates ‘skilled and competent’. Bedside clinics should not be the only means for practical training. Simulator-based training has a great potential and will appeal to a generation of youth addicted to Playstations and online gaming. Making students an integral part of the ‘medical team’ will give them a sense of belonging and will allow them to learn the practical aspects of dealing with patients. So many aspects of medical training like communicating with patients and breaking bad news can be seamlessly integrated into ward rounds. A shift to a syndromic approach based on practical reasoning rather than learning esoteric syndromes by rote is another strategy. The Medical Council of India wants medical education to be recalibrated to produce medical scientists rather than just doctors. Getting students involved in research early is a good idea. But research too requires practice. Practise in designing studies that will stand scientific scrutiny and in meticulous data recording. In short, medicine is like music or any art form requiring constant reiteration and revisions.Aficionados of contemporary jazz will be familiar with the song ’Music of the night’ from the famous musical Phantom of the Opera. The phantom refers to his music as ‘hard as lightning, soft as candle light’. Our education should be such that our doctors are hard with facts and practical skills which they can marshal at the speed of lightning and execute with a softness that the art of medicine demands. The editorial team of “Praxis” has tried to incorporate all these three aspects of medical education into this journal. Review articles, clinical approaches presented as flash cards, and original research work by students have all been incorporated in this journal. It is hoped that just like the Young Researchers Forum, Praxis too will evolve into something substantial with gravitas and momentum. ‘Hard as Lightning, Soft as Candle Light’EDITORIAL
Background: Neurological complications involving central and peripheral nervous system are well described but there is paucity of literature on involvement of autonomic nervous system. HIV patients on ART have a higher prevalence of symptoms due to dysautonomia in comparison to normal individuals.Aims and objectives: To study the prevalence of cardiac autonomic dysfunction in PLHA (People living with HIV/ AIDS) with and without antiretroviral treatment.Methodology: It is a cross sectional study. The subjects are broadly divided into 3 categories with 25 patients in each group. PLHA on ART, PLHA not on ART and healthy controls.Observation and results: Three patients from ART group two from ART naive group had symptoms of syncope. There was a significant difference between the autonomic parameters in the control population as compared to that of PLHA, but no difference between those on ART and not on ART. The resting heart rate was significantly higher in PLHA compared to controls. On testing for sympathetic response, there was no notable difference between the median values of fall in systolic blood pressure between PLHA patients and control population. Respiratory sinus arrhythmia, expiration to inspiration ratio, in the controls was higher when compared to PLHA There is a significant difference in fall in systolic blood pressure between the HIV on ART and not on ART, however there was no significant difference in other autonomic parameters.Conclusion: This study shows that deterioration of parasympathetic function is more common than sympathetic function decline in HIV infected subjects as compared to normal population.
Aim and Objectives: This study aimed to assess the morbidity profile and health care needs of elderly veterans and their elderly dependants residing in an urban gated society. Methodology: This cross -sectional observational study was done by house to house survey of veterans and their dependents more than 60 years residing in gated urban cooperative housing society. A predesigned questionnaire to assess the comorbidities (lifestyle diseases, geriatric syndromes, and reversible disabilities) and perceived health-care needs was administered. Data were analyzed using descriptive statistics by SPSS 22 software. Results: Four hundred and six elderly veterans and their dependents were interviewed, which included 53.7% females. The mean age was 71.69 years. It was noted that 14.5% of the veterans were staying alone and required the help of a caregiver hired from outside. Chronic noncommunicable diseases (CNCDs) were common with more than 70% of veterans having two or more comorbidities. Hypertension was the commonest disease with a prevalence of 51.5% followed by diabetes (30.8%), decreased vision (28.6%), dental problems (25.1%), osteoarthritis (19.7%), and hearing impairment (18.7%). Only 4.2% of the subjects gave history of falls. Malignancy and chronic obstructive pulmonary disease were reported by 3% each. Dementia was prevalent in 14.5% of the subjects. The greatest felt needs of the elderly were: A separate geriatric outpatient clinic, availability of transport for elderly within the hospital, separate queues at the dispensary and blood collection centres, and a geriatric helpline. Conclusion: CNCDs were present in more than 80% of elderly subjects surveyed. Hypertension was the commonest comorbidity followed by diabetes. Potentially, treatable disabilities were seen in one-third of the veterans. Separate geriatric clinic, separate facility for dispensing medicine, and blood collection centers and a geriatric helpline were the most felt needs by the elderly veterans and their dependents.
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