Family Adoption Program for Undergraduate Medical Students at a New Medical School of Jharkhand: An Experience and SWOC Analysis.

Introduction: Family adoption program (FAP) incorporated into the undergraduate medical education curriculum is beneficial to all stakeholders involved. Many medical colleges have started FAP at different times and various levels based on resources availability, feasibility, and accessibility. This article is intended to cover the process of FAP implementation, the strength, weakness, opportunities, and challenges at various levels, and its scope in future. Methodology: FAP was launched by adopting a hamlet 17 km away from the college. During the foundation course, orientation lessons and logbook discussions were conducted online before the actual field visit. During the initial visit, families were assigned, which was followed by collecting sociodemographic information, a plantation drive, and organizing medical camp/ door to door screening in the last visits for phase one students. Observations: The strengths perceived were early community exposure of students and leadership skills, and the weaknesses were allocating adequate number of slots in the curriculum, adopting families far away, etc., Similarly, FAP has an opportunity to achieve the larger goal of Heath for All in terms of identifying, following up, and managing various socio clinical cases in the adopted families. However, few challenges can pose as it progresses across other phases, such as language problem, allotment of problem families, existing social pathology in family, cultural taboos, etc. Conclusion: The article suggests that once a student leaves, another student should continue the cycle of adoption and provide continuum care of services to prevent the family from being orphaned.

Prevalence of Multidrug Resistant Pulmonary Tuberculosis in North Bihar.

INTRODUCTION: Multidrug resistant tuberculosis (MDR-TB) is caused by Infection with Mycobacterium tuberculosis which is resistant to both isoniazid (INH) and rifampicin (RIF), with or without any other anti tubercular drug. It is caused by resistant mutant strains due to inadequate treatment and poor compliance. Due to time taking conventional diagnostic methods, drug resistant strains continue to spread. Therefore rapid diagnosis and treatment of MDR-TB strains are prerequisites for the worldwide fight against TB. OBJECTIVE: To determine the prevalence of MDR TB in North Bihar by molecular diagnostic method and to facilitate early diagnosis and treatment. Also, to find out the number of those diagnosed cases who were successfully initiated the treatment in MDR TB Centre of DMCH. MATERIALS AND METHODS: This six month observational study was carried out in IRL Darbhanga, Damien TB research Centre of the Darbhanga Medical College and Hospital, Bihar, India. During the period of February-July 2014, 256 sputum samples were collected from suspected cases of multidrug resistant tuberculosis, from 6 districts of North Bihar around Darbhanga. These samples were subjected to routine microscopy and culture to detect Mycobacterium tuberculosis. Positive cases were subjected to drug sensitivity test by a molecular diagnostic method, Using Genotype MTBDR plus kit. RESULT: Out of 256 sputum samples from suspected cases of MDR TB, 122 cases were microscopy positive for tuberculosis. Among these 122 cases, tuberculosis was confirmed by PCR in 114 cases. Finally with the help of Line Probe Assay (LPA), 39(15%) samples were found to have resistance to both INH and Rifampicin. Male female ratio was 4:1. CONCLUSION: The Prevalence of Multi drug resistant pulmonary tuberculosis in North Bihar is 15%. It needs early diagnosis by molecular diagnostic method and prompt treatment to reduce the spread of MDR TB cases.

The role of serum protein electrophoresis in the detection of multiple myeloma: an experience of a corporate hospital.

BACKGROUND: Multiple Myeloma (M.M) is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells, secreting abnormal immunoglobulin causing monoclonal gammopathy which can be detected by the presence of M protein in serum and urine electrophoresis. AIM: To detect and quantify monoclonal gammopathy in suspected cases of multiple myeloma and to differentiate them from benign conditions, because of the vast difference between their prognosis and management. METHOD: Serum samples from 150 suspected cases of M.M were subjected to serum protein electrophoresis on cellulose acetate strip. M band detected visually and estimation of M protein was done by densitometer. Bone Marrow biopsy and clinical profile were correlated in M band positive cases. RESULT: Out of 150 cases 10.66% cases had monoclonal gammopathy. Ten percent cases were diagnosed to be multiple myeloma and one case was found to be Monoclonal gammopathy of undetermined significance. CONCLUSION: SPEP is an easy to perform laboratory test which can be used for detection and quantification of monoclonal gammopathy and should be recommended as preliminary test for suspected cases of multiple myeloma. MGUS must be differentiated from M.M, as management and prognosis of these two cases is totally different.