ABSTRACT
Background Pilonidal sinus disease (PSD) is a chronic skin condition caused by hair retention that affects the sacrococcygeal cleft. The purpose of this study is to compare the efficacy of negative pressure wound therapy (NPWT) to routine daily dressings (DDs) in wound healing after complex or infected pilonidal sinus tract excision. Materials and methods The study included 81 individuals who had extensive local excisions for pilonidal sinuses that were complex or infected. Randomly selected participants were given either NPWT or the usual dressing. Between the two groups, the length of hospitalization, the amount of time needed to resume daily activities, and the amount of time needed for full wound closure were compared. Results Forty-two patients received NPWT, while 39 patients received DDs as usual. There was no discernible difference between the two groups in terms of operating time or hospital stay. However, patients who underwent NPWT experienced a quicker final wound closure (59.24 ± 10.21 days compared to routine DD with a mean time of 75.31 ± 14.68 days, P = 0.001) and returned to normal activities earlier (17.36 versus 21.75 days in NPWT and routine DD, respectively). Conclusion Compared to patients who received standard DDs, those who were postoperatively managed with NPWT showed faster wound healing and return to normal activities. Whenever feasible, this strategy may be employed to improve patient recovery.
ABSTRACT
Context: Getting residency training abroad is a critical motivator in the emigration of Indian medical students. Brain drain is an emerging issue, especially for developing countries as it causes a shortage of trained staff in the donor country. Aim: We aimed to survey Indian medical students to know about their intentions to get trained abroad and to understand the factors influencing their decision. Materials and Methods: In this cross-sectional observational study, we surveyed Indian undergraduate medical students of all professional years, including internship. A validated questionnaire collected data on students' demographics and educational characteristics, intention to study overseas or stay back in India, and factors influencing their decision. Results: Out of a total of 1199 responses (51.1% males, 48.9% females), 45.0% partakers had planned to pursue their residency abroad, while 33.8% wanted to stay in India and 21.2% were undecided. Better lifestyle and higher pay grades overseas were viewed as the most significant barriers to staying back in India and a key influencer in decision-making among the maximum number of students (412; 76.3%). On the other hand, a whopping 58.2% of participants opined that they wanted to stay back in India for taking care of their parents. Conclusions: Source countries with better healthcare facilities and better incomes tend to attract medical students. Awareness among medical educators regarding constantly changing curricula, a shift to a competency-based education system, better pay grades, limited working hours, and interventions to mitigate workplace violence could help prevent brain drain among Indian medical students and graduates.