Revista Medicos #14

EDITORIALS The Future of Medicine; Referred Pain from Ukraine

AMSA EVENTS Recap of all the events happening in the quarter

READERS’ ARTICLES

NEW SECTIONS

Nemo Malus Felix; The Vices of the healers

Women's Health; Breakthrough Innovations

REVISTA MEDICOS AMSA India’s Quaterly Newsletter

TURMOIL OF THE TENSION TRAID Covid, Exams & Travel Issue 14 | May 2022

03

About us

05

Letter from Regional Chairperson

10

13

15

17

Future of Medicine

Sports in the COVID Era

Referred Pain from Ukraine

Handling Exam Stress

28 25

Memes

34

Nemo Malus Felix

Plight of Medical Students in Ukraine

37

Vices of the Healers

06

Letter from Secretary

07

Note from Editor

08

of

Meet the team

TABLE CONTENTS 19

Women’s Health

29 Exam Stressors & Solitions

39

AMSA Events

21

23

Breakthrough Innovations

Research Series

30

32

No Pain, No Gain

48

Our Partnerships

Sports after the Pandemic

About us.

AMSA India represents Indian medical students interests in all the spheres of our society and thus provides an excellent platform for empowerment. The activities involve medical students in participating in various national and international conferences, academic bonanzas and philanthropic work. The directive of our organization is to inform, educate and counsel every medical student of India. The international activities Conference EAMSC are (January/February), AMSC (Conference: July/August) and AMSEP (Student exchange).

AMSA was officially founded in Manila, Philippines in the year 1985, it is an active, dynamic and exciting student-led, not-for-profit and nonpolitical organization with 27 member associates and observer nations.

AMSA'S vision is knowledge, action, friendship Le to share knowledge, undertake activities and social services and create International and intercontinental friendships that lasts forever.

About us.

Our Spanish title articulated with love, toward a magazine for and of medicos. To describe this “Spanglish” (Spanish + English) title with soul of medicine and in words of a poet:

Newsletter is the mirror of an organization’s play, The gospel truth and our belief we say.

The essence of our organization as detailed is told, And all the future aspirations as destined we unfold.

To keep the idea of ‘medicos’ atop, From clinical questions and crosswords to interviews, We’ve got you covered with thought.

As in a democracy, our organization solely stands by members, for members and of members that’s what makes it grand.

Alas, your love and feedback is what is indeed craved, because in unison are the trails of success paved.

LETTER from the Regional Chairperson

D Dear Readers,

It feels like a great privilege to be able to converse with you all via the medium of the 14th issue of AMSA

India’s treasured newsletter, Revista Medicos.

‘Turmoil of the Tension Triad: Exams, Covid & Travel’, the theme of this issue’s newsletter very well resonates with AMSA India’s role as a medical students organisation in the first quarter of its term as the new board, wherein we formed a Covid Support National Working Group with 1300+ volunteers aimed at helping the general public get easy access to emergency resources such as oxygen cylinders, hospital beds, medicines among other necessary medical supplies. With the second wave settling down, the board shifted back its focus to bring around a broad range of events ranging from research to public health, virtual exchanges to academic competitions along with the launch of our two new units, namely Bioethics and MSFC. I would like to take this moment to congratulate the brilliant visionaries behind this newsletter- Chitwan Ghuman (Secretary Newsletter) and Samneet Singh (Chief Editor Newsletter) and the whole Editorial board for curating it very thoughtfully while documenting the exceptional contributions of the members of AMSA India. We hope that you have an enthralling experience while reading through the newsletter.

We are also excited to share that AMSA India is now a family of 7000+ medical students as members. We thank you for your continued interest and support. With many interesting avenues opening up in the next quarter, we hope to welcome more new members to the family. Till then, Stay Tuned and Curious.

‘Empowering Minds, Enhancing Performance’ VivaAMSA!

Khushman Kaur Bhullar Regional Chairperson AMSA India 2021/22

From the

SECRETARY'S DESK

D Dear Readers,

“A single arrow is easily broken, but not ten in a bundle.”

Throughout the history of nature, the collective has proved stronger than the sole creature. Teamwork has played an essential part in the progression of mankind. Hence, I thank the Regional Chairperson, Khushman Bhullar for appointing me as a part a marvellous team, where I chose my bunch of gems- Anshdeep Singh, Arnav Bansal, Drashti Patel, Guari Mehta, Karthik Shankar, Pragya Chand, Roop Kaur Brar & Soundarya Prabhakar, who done double duty for you, my readers, to enjoy the quarterly Newsletter of AMSA India, The Revista Medicos.

The issue, Healing the Healers, would focus on the various aspects of a doctors’ remarkable everyday regime during this Pandemic. Doctors are selfless and devote their lives in order to eliminate ailments, but still we as Medicos’ faced various unsaid and not cared for problems ourselves while healing others. We hope this issue of Revista Medicos, helps our healers to heal themselves in whatever way possible.

Towards the end, we would love if our readers could spare some time to help us remove our shortcomings by filling out the review form attached in the end. And if you have any queries regarding the Newsletter please feel free to contact me at newsletter@amsaindia.in Appreciatively

Chitwan K Ghuman Secretary Newsletter AMSA India 2021-22

From the

EDITOR'S DESK

T

“The oak fought the wind and was broken, the willow bent when it must and survived.”

Resilience is not just standing upright at times adverse but it is accepting your new reality, bending to it and then standing back again.

These unpredictable times we have witnessed, not just to maintain the pace but also the quality of newsletter was our prime objective and In this Issue, the essence of rising again after the fall and standing back stronger is well brought about through the major subthemes. Keeping in mind the Mental health issues and the post Exam stress, we have made the best of our efforts, not just to be vocal about them but also to suggest remedies for them. Not just this also the other themes emphasising the triad of stressors Exams,Covid and travel ban are well represented.

I’d extend my heartfelt gratitude to the Regional Chairperson, Khushman Kaur Bhullar, AMSA India 2021-22, for the unwavering faith in me and Chitwan Kaur Ghuman, Secretary of Newsletter for being an amazing co-lead and Of course, to the heroes under the veil, and My team: Gauri Mehta, Drashti Patel, Pragya Chand, Karthik Shankar, Arnav Bansal, Roop Kaur Brar, Soundarya Prabhakar and Anshdeep Considering the vast diversity we represent, it becomes our utmost duty to live up to the aspirations and demands of our readers and So, I humbly request our readers to please fill in the feedback form and in case if you have any queries regarding the Newsletter, please feel free to contact me at Editor@amsaindia.in.

Regards

Samneet Singh Chief Editor of the Newsletter AMSA India 2021- 22

MEET TH

NATIONAL OFFICERS, EDITO

An amicable, empathetic, tech savy and Socially awkward procrastinator in her second year MBBS who enjoys editing and creating digital art as much has she loves medicine. She'll probably go miles to make people smile, and believes that kindness is the ultimate virtue. The 19 year old also has an unusual amount of love for plants :)

A student of Sri Muthukumaran medical college, Chennai.

A lazy perfectionist who gets the job done with meticulous care to detail and possesses an expansive skill set and a knack for design and editing.

She patterns herself from the way she perceives nature and life.

A 2nd Year MBBS student at Maulana Azad Medical College, New Delhi.

Being a budding designer and a shooter, he is always curious and enthusiastic to learn new things, he believes there is nothing in the world that you can’t achieve with honest hard work.

A final professional part 1 medical student from Dayanand medical college, Ludhiana. He has a clear, logical mind with a practical approach to problem solving and a drive to see things through to completion. He is a person with fantastic eye for detail, and enjoy order, precision and efficiency in all tasks.

HE TEAM

ORIAL BOARD, AMSA INDIA (21-22)

A med student who lives by the simple motto, to aspire to be cognizant and attempt to seize knowledge in any and every form possible. From academics and healthcare to literature, flow arts and cinema she enjoys and appreciates the essence each of these impart.

A 2nd Year Med student passionate about Football, Films and finding solace in this crazy game called Life.

A not-so-regular third professional student who finds solace in books and poetry.Both Robbins and Oscar Wilde render her equally awestruck,while medicine is her passion,literature is her raison d’être.The concept of holistic treatment of both mind and matter inspires her and her mind palace is an abditory of all-things-delightful. Certified aesthete,she-flaneur and a philocalis, the woman swears by her dynamic playlist and believes in leading The Jedi Life! However,the seemingly quiet hedonist blooms into a loquacious lass once strum to her frequency.

She is an intern at AIMSR. Being confident, expressive and an idealist, she is a firm believer of the fact that power resides where you believe it does. Her infectious enthusiasm and fiery persona makes her unforgettable in every task she undertakes. It’s her hustle and heart that sets her apart. Her passion for Medicine and Surgery drives her to be a healing touch for those in need. A culinary comforter who is able to rustle up mouth watering treats to melt away all stresses. She adores dogs and is always up for an adventure.

The current challenges in healthcare will shape the future of medicine in a way that will benefit the interests of patients, doctors, allied healthcare workers, scientists, policy makers and communities. As the needs of the healthcare services change, there are advances in training, technology and scientific research that help to provide diagnosis and treatments of diseases. Along with the need for new technology and medicines there is a pressure on the medical workforce to adapt to these changes while providing quality healthcare.

Thus, one needs to look at various parameters where changes are occurring such as the changing needs of patients, workforce, hospital settings, digital and technological advances and the innovations in treatments and preventive care to better explain the future of medicine.

The physician of the future will have to be equipped with the skill sets and attributes that are both human and technological to provide the best quality healthcare in the 21st century. Our doctors, health care workers and services will be shaped by COVID 19 pandemic and its impact that has shaken the entire world like never before.

In order to succeed medicine in future requires a ‘holistic approach’. Holistic care paradigm requires the physician to lead healthcare services in collaboration with allied healthcare practitioners. The roles will evolve in such a way that healthcare practitioners like nurses, and support staff will compliment the new physicians with flexibility in the roles.

New training programs will impart skills to ensure fatigue and burnout do not impede the overworked healthcare practitioner. Focus will be on imparting training to increase dual or multiple speciality doctors to meet the demand of the population.

FUTURE OF

MEDICINE

BY DR. ROOP KAUR BRAR

Emphasis will be on developing novel ways for teams to work together towards a stated goal for getting patients to a point where they no longer require excessive care. Models such as ‘Buurtz org Model’ of care will be better than practitioners working in isolation within the profession in order to meet the healthcare needs of a growing population.

Doctor Patient Partnership

The partnership between doctor and patients will increase the ambit of healthcare services in the future. The patients willing to opt for home care will benefit along with the aged patients who do not require complete hospitalisation but need day to day care. The use of internet, patient forums, societies, etc will allow patients to communicate with one another about their healthcare requirements. They will expect the doctor to lead in the line of uncertainty but will be more actively involved in their treatment options

Use of Technology in Healthcare The use of artificial intelligence and robotics will exponentially increase thus rapidly improving the working lives of future physicians. Machine learning will aid practitioners in forming diagnoses. Large amounts of data will be interpreted by computer programmes. It is important to update the healthcare systems to understand and use artificial intelligence to their advantage. Sifting through piles of data and making sense of reams of electronic data about patients such as medical imaging, histories, sleep patterns, heart rate, etc will be done by artificial intelligence. Here complex identification of patterns is done in short time leaving the doctor free to deal with the patient on a personal front and make important decisions about treatment plans.

As the ‘Topol Review’ recommendations reveal natural language processing will be widespread by 2030 and automated image interpretation and predicting analytics by 2035, it is time to prepare the new generations of medical practitioners through education and training to deliver the digital future by mastering the use of artificial intelligence and robotics. In future the physicians will not be able to work without advanced technologies as patients will be using wearable devices to the maximum and bringing in large amounts of data to the consulting room.

Preventive Medicine As the increasing populations are falling prey to diseases both communicable and noncommunicable thus prevention of diseases is the future of medicine. Identifying, studying and minimising the disease causing risk factors among the people will afford protection to millions at risk. Massive education programs and awareness drives supporting primordial prevention through community programmes is the need of the coming years.

Changes in the environmental factors and behaviours through lifestyle, diet, etc need to be brought about to achieve the health targets of the future. Health behaviour research is the future which will ease the burden on health care providers and decrease the growing menace of diseases.

Thus building a healthcare system equipped to deal with the future hurdles through proper training and education in preventive medicine is imperative. Along with this, widespread education programmes through media, linked with public healthcare departments and health insurance companies will provide specialists who will help focus on helping people before they fall sick. The goal is to prevent health issues before they need treatments where the doctor is in the lead role.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

-Pragya Chand

HOW A COUNTRY’S CIVIL WAR IS AFFECTING INDIA’S YOUTH AND ACADEMICS The recent catastrophe and “holocaust” that ensued in Europe’s second-largest democracy has been making headlines for months now. The 21st century was unfortunate to re-witness a mass genocide along the same lines of an event that brewed World War II and it would be a mockery of the facts if we do not expect the likeliness of similar happenings shortly. The condition has been disconcerting for not only the involved but also for the adjacent and peripheral nations.

The distinguishing fact between the earlier wars and the one currently in action is the sequelae it has on a much bigger nation, in the discussion, India. Ukrainian crisis has irreparably affected the lives and career aspirations of over 20000 Indian students. India boasts of the world’s most diligent minds but in one way or another our nation has failed those 20000 to the extent of crossing a dozen LOCs just to fulfil their dreams which might I add, actively and primarily involve the nation’s healthcare and thus, the nation’s future.

Over 15 lac students appear for the NEET exam every year and then no. Has only multiplied, the increase in medical seats is an agenda unheard of in parliament houses while they discuss “more indispensable” topics such as the screening of a “specific movie” unearthing hidden propaganda and atrocities of ruling parties. The government was audacious enough to comment on the attitude of students when they landed in their homeland.

Fortunately, all our students have been towed back safe and sound and even though the possibility of a stable career is out of the question, they are congratulated for making it home safe, and ALIVE. Now, the question arises,” why go abroad to pursue medicine”, and in the words of Hon'ble PM,” Why go to particularly smaller nations”?As rhetorical as the question may seem, it does have answers which are not voiced. Interrogate every Ukraine returnee student and enquire if even one of them primarily aspired to leave their homeland, their family to set up camp in a nation unheard of. Along with financial adjustments, there are cultural repercussions that do not go inconsequential in the long term. Foreign students are expected to be wellversed in the local prevalent language and that directly or indirectly, alleviates the grip of our culture. Guardians “invest” their entire life savings into making one doctor.

Private medical colleges in India are out of the question in this scenario since their admission criteria must also include a “status quo” vertical as only a handful can afford it.

If only there was better academic administration, better amenities or steadier resources and most importantly more slots for the fulfilment of dreams, our students wouldn’t have to venture abroad. This acutely perceptible consequence of our youth was entirely uncalled for had there been better arrangements in our home country. Indian minds have proved their mettle since time immemorial and better opportunities would not only hone their futures but ours together as a nation

KARTHIK SHANKER

The pandemic has had a lasting effect on all walks of life, be it education, healthcare, industry etc.But one major sphere severely hit by COVID-19 has been sports and sporting events.

Let's take a look at some of the most popular sporting events that were severely hamstrung by the pandemic-

CRICKET In July 2020, the International Cricket Council (ICC) announced that both the 2020 and 2021 editions of the ICC Men's T20 World Cup had each been postponed by one year due to the pandemic. This meant that the 2020 tournament was moved to November 2021, and the 2021 tournament was moved to October 2022.

Also, on the 13th of March 2020, the Board of Control for Cricket in India (BCCI) announced that the start of the 2020 Indian Premier League will be postponed from 29 March to 15 April. On the 16th of April, BCCI suspended the tournament indefinitely due to the pandemic and on 4th June, the BCCI announced that IPL will stage outside India.

TENNIS On the 16th of March, the start of the 2020 French Open was postponed from 24th May to the 20th of September and then to the 27th of September, whilst on the 1st of April, Wimbledon was cancelled for the first time since World War II.

FOOTBALL Various knockout matches in the Champions League and Europa League were played behind closed doors in February and March 2020, but owing to an increase in caseload, UEFA was forced to postpone all fixtures in the Champions League, Europa League and Youth League for an indefinite period, only resuming in August.

On 13th March 2020, English elite football was suspended, including the Premier League and the English Football League, only resuming in June 2020.

OLYMPICS Arguably the event most prominently affected by the Pandemic was the Tokyo 2020 Olympics. The 2020 Summer Olympics and Paralympics were scheduled to take place in Tokyo starting 24 July and 25 August respectively.

Unable to curtail the rising cases, on the 24th of March 2020, the IOC and Tokyo Organizing Committee announced that the 2020 Summer Olympics and Paralympics would be "rescheduled to a date beyond 2020 but not later than summer 2021", marking the first time in the history of the modern Olympics that an Olympics has been postponed. The opening ceremonies of the Games were officially rescheduled to 23 July 2021. The cost of postponing the Olympics to 2021 was estimated to be an incredible US$5.8 billion.

THE EFFECTS OF THE CANCELLATION OF THESE EVENTS GO BEYOND THE LACK OF ENTERTAINMENT FOR ITS VIEWERS. THE PANDEMIC HAS RESULTED IN ECONOMIC LOSSES FOR THE STADIUMS AND TEAM WORKERS WHO STRUGGLED TO MAKE A LIVING DURING THESE TIMES. THANKFULLY, SPORTING EVENTS HAVE NOW SLOWLY BUT SURELY RESUMED IN FULL SWING PROVIDING ENTERTAINMENT FOR MILLIONS DESPERATE FOR THEM TO RESTART.

Handling Exam Stress - Gauri Mehta

In times of Peril, we Prevail: How to overcome exam stress The exam season is often perceived as a dreaded state of affairs. From sleepless nights, unremitting stress to of course, a herculean syllabus, it’s demanding to keep the mind at peace and pace forward at ease.

As budding medical professionals, we read about how meticulously the human body works in stress. It’s just about enigmatic the way the body is built to face a strenuous situation- the ‘Fright or Fight’ response. The autonomic system with due regard to the type and extent of stress helps us cope to it’s best form, indeed a conscientious system.

However, also as medical professionals we’re reaching the breakpoint of such run-of-the-mill stress time and again. And day after day, the various forms of the stress we face, builds up, deeply seating into our subconscious.

Sadly, most medical institutions lack the ideal mentorship required to alleviate the exam stress faced by students. Most seek support from friends, seniors and teachers and sail through difficult situations, others dismally lack guidance resulting in unhealthy coping mechanisms.

To excel, we must make the most of our abilities, keep our cool and carry on forward. Here are some evergreen tips and tricks for this process-

To set realistic Goals: One needs to understand that exams are not a ‘Do or Die’ situation but just a modality to assess our understanding of the subject. Thus, take it as a challenge rather than consider it the end of the world.

Read for leisure: the art is in making the mundane study curriculum interesting and so a safe space to reside in.

Be proactive through out the year; Try to gather information in any and every form from any whatever source possible, whether it’s quizzes, co curricular events, social campaigns or clinics. It will work wonders.

With exams around the corner: Plan well in advance! But more importantly, honestly follow your individualized study schedule.

Take breaks- perhaps the most important suggestion. Find your way of letting loose, even if it’s just for 10 minutes during the day.

During exams: watch your pace and practice as per the clock. Prioritize the important topics.

Declutter: Your desk, your surroundings, people around you and of course your mind.

Stick to basics- they go a long way.

Avoid the perfectionist trap; to quote, ‘Best is the enemy of good’ is distinctly pragmatic.

The mind is not a machine, alas it requires rest.

Take rest, have a healthy mindset and be kind to yourself.

“Don’t let what you cannot do, interfere with what you can do” Handling stress in the face of exams is genuinely burdensome, thus the key lies in sailing through the storm with an aim to achieve what’s awaiting at the other end.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

WOMEN’S Health REVISTA MEDICOS | ISSUE 14

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

REVISTA MEDICOS | ISSUE 14

BREAKTHROUGH INNOVATIONS

PSMA-TARGETED THERAPY IN PROSTATE CANCER

Accurate imaging is critical for tumor localization, staging the disease and detecting recurrences. PSMA, an antigen found in high levels on the surface of prostate cancer cells, is a potential biomarker for the disease. PMSA PET scans use a radioactive tracer to attach to PSMA proteins, which are then combined with CT or MRI scans to visualize the location of prostate cancer cells.

NEW TREATMENT FOR THE REDUCTION OF LDL High levels of blood cholesterol, particularly low-density lipoproteins (LDL-C), are known to be a significant contributor to cardiovascular disease.

Inclisiran is an injectable small interfering RNA that targets the PCSK9 protein. In contrast to statins, it requires infrequent dosing (twice per year) and provides effective and sustained LDL-C reduction in conjunction with statins.

NOVEL DRUG FOR TREATMENT OF TYPE 2 DIABETES Thus far, late phase III clinical trials reveal that the treatment significantly reduces haemoglobin A1C in type 2 diabetes and supports weight loss, making it potentially the most effective therapy for diabetes and obesity yet developed.

BREAKTHROUGH TREATMENT FOR POSTPARTUM DEPRESSION Currently, counselling and anti-depressant medications are the primary treatments but some women do not respond to these therapies. This novel therapy, administered around the clock for 60 hours, uses a neurosteroid to control the brain’s response to stress. This treatment design is groundbreaking as it targets the signalling thought to be deficient in hormonesensitive postpartum depression.

TARGETED MEDICATION FOR HYPERTROPHIC CARDIOMYOPATHY The FDA has assigned a target action date for this therapy of April 28, 2022. If approved, this would be the first medication explicitly dedicated to treating HCM and providing new hope to patients and physicians.

IMPLANTABLE FOR SEVERE PARALYSIS The technology uses implanted electrodes to collect movement signals from the brain and decode them into movement commands. It has been shown to restore voluntary motor impulses in patients with severe paralysis due to brain, spinal cord, peripheral nerve or muscle dysfunction.

AI FOR EARLY DETECTION OF SEPSIS Artificial intelligence (AI) has surfaced as a new tool that can help rapidly detect sepsis. Using AI algorithms, the tool detects several key risk factors in real-time by monitoring patients’ electronic medical records as physicians input information.

Continuing from Issue 13s topic on finding a research topic, we present to you another vital aspect of presenting a research paper- The Literature Review.

A literature review defines the review of existing books, scholarly articles or research papers, research findings as well as theoretical and methodological contributions to a particular topic.

Literature Review in research is a fundamental part. Researchers begin a literature review immediately after choosing a research question or formulating a research problem. There must be sufficient knowledge of the subject in which the researcher intends in researching. So, he has to gather all the research that has been done in the past regarding the research topic that is currently underway.

The general objectives are to help the researcher on the theoretical basis of the previous research and to help improve their work.

Key Considerations:When you study the literature, you should be careful in the following considerations to make a good literature review for your research so that it would go in the right process.

The scope of the research study, hypothesis, and what are the variables used in the research.

The specific field for a research study, for example, what area, city, village, or slum and population.

If it is sample-based research, which method of sampling has been used?

If it is case study-based research, then, why case study, and what characteristics defined this case study?

Which method of data collection has been used and why?

How is the data analyzed? Qualitative or quantitative and why?

The limitations of the study which the researcher acknowledged.

What are the recommendations based on the findings of the study?

Objectives of the Literature Review To identify the relationships between the existing research works with others.

To explore new ways to describe previous research.

To find out the gaps in the existing literature if there are any.

Conflict resolution from contradictory previous research.

To point out why there is a need for this particular research.

Take a look at this example of a snippet from a literature review in a published research paper, that will help you structure yours as wellTopic- Stress and coping for adolescents ( By John Smith, James Cook University) Literature Review Adolescence is the transition between childhood and young adulthood during which young people experience physiological, cognitive and social changes (Dumont & Provost, 1999; Murberg & Bru, 2004). The age bracket for adolescence varies according to different literature (de Anda et al., 2000; Spirito, Stark, Grace and Stamoulis, 1991) however this paper defines adolescents as between 12 and 19 years of age.

Williams and McGillicuddy-De Lisi (1999) suggest that during this transition, young people have difficulty adjusting and often struggle with unfamiliar issues. Stress is a concept that cannot be explained using a static definition thus it is important to be aware that different descriptions exist in both recent and seminal literature. Delahaij, Dam, Gaillard and Soeters (2011) explain stress using a biopsychosocial approach, suggesting that stressful reactions affect the emotional, physiological and cognitive state of an individual. This definition describes stress as a reaction. Alternatively, Caltabiano, Sarafino and Byrne (2008) view stress as a discrepancy.

A well-performed literature review helps your research correct any faults in previously conducted similar studies, and helps you improve upon them.

MEMES MEMES MEMES MEMES MEMES MEMES MEMES MEMES MEMES

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Contributions from our Readers

PLIGHT OF MEDICAL STUDENTS IN UKRAINE

Once crammed with sights to behold, the country is now vandalized manifold.

Brimmed with med students from multiverse of nations, now in a quagmire to abandon their education. students left destitute in underground shelters, vulnerable to turmoil in nearby chambers.

Bunkers shielding the students from explosion, But unable to provide the dispute ,a solution.

Perplexed and frustrated in a dicey situation, anticipating for the delegacy to expedite the solution.

A reason being the relentless rules, Students impotent to furlough their Med schools. deprivation of food ,water and electricity, proved barely greater than the unescapable ferocity unforeseeable thoughts of “what about the next moment?” made the situation more despondent. like a damned river denied consent to flow, Students craving to meet their raisers added misery to the row.

Nikita Limje 2nd year MBBS student of IGGMC, Nagpur.

Did her schooling from St. Xavier’s High School, Nagpur.

Her hobbies are composing poetry, wildlife photography, exploring new places and playing badminton.

EXAM STRESSORS & SOLUTIONS Exams are near Why to fear But nothing is clear What is going to appear Just a few days remaining Our mind keeps blaming Then we start preparing And start explaining When my back starts paining I start lying When the exams are stressing I start meditating Even after learning thrice I find myself mundane When asked any question I forget again and again Watching videos solving cases settled them in my brain Which I remembered as a story tale Reading books gave me strain All I needed was to review my notes again The course is too much and time is less I Divide the topics, by the days left When one topic gets finished Then I make questions to flourish Final day of exam arise Where I see mostly cries The fear ranging in my eyes Then I get the surprise Of seeing the questions that I did revise

Dr. Kirti Agarwal She’s studying as FMGE student at China three Gorges University.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

With the onset of a pandemic, came many changesunique yet coupled by their common quirk of being ‘unexpected’. The general population has been inured to pain as a consequence of circumstance, augmented by its high prevalence and the cultural attitudes towards suffering. However, it is extremely important to stress on the fact that commonness does not equal triviality.

The responses to COVID-19 had expected and unexpected consequences; Immediate and delayed consequences; Mild and severe consequences.

Systems thinking encourages us to look at any given situation as a system where each part affects the whole and each part is necessary but insufficient for the system aims. Just as importantly, effect on any part affects the whole but to varying degrees. This article attempts to bring your focus to a similar phenomenon where interventions aimed at reducing the transmission of this respiratory virus led to the deconstruction of chronic pain/condition management services.

Health monitoring services offered to patients with chronic diseases were affected first since they were deemed as ‘non-essential public health services’. With disconnected monitoring, came the worsening of patient condition which was addressed neither objectively nor subjectively.

Dr. Japmehr Sandhu She is completing her internship at Government Medical College and continues to question all that she comes across on the daily in an attempt to understand her passions better than the day before.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

Treatment interruptions were also documented in tuberculosis and other therapy distributive systems.

Hospice care was even harder during the pandemic given the association between care homes and COVID outbreaks.

Moreover, centres experienced a shortage in analgesic medications due to panic-buying. Continuation of treatment for chronic pain disorders was reconsidered entirely; due to the facile knowledge of referred pain and diffused aches as a common symptom of COVID infection.

The risks of undertreatment were exacerbated by the fragile mental health statuses worldwide and poor management of chronic pain during the COVID-19 era was linked to hopelessness, social detachment unemployment, insomnia, poor quality of life and depression.

To overcome these challenges, patients have been encouraged to partake in telemedicine care and caretakers have been advised to continually screen for pain intensity.

Elective pain procedures were suspended temporarily.

Patients on opioids must be given more attention due to the potential for misuse- previously linked to higher rates of suicidal overdoses. A joint statement had been put out by the American Society of Regional Anaesthesia and Pain Medicine (ASRA) and European Society of Regional Anaesthesia and Pain Therapy (ESRA) stating the importance of triage. Intrathecal Pain Pump refills and malfunctions or even neurostimulator device infections were classified as urgent procedures. Semi-urgent procedures worth remembering included intractable cancer pain, Acute Herpes Zoster, herniated disc or worsening lumbar radiculopathy, intractable trigeminal neuralgia and acute cluster headaches. Early complex regional pain syndrome was also included in this category. Such cases were advised to avoid emergency room (ER) visits and opioid reliance. Instead, patients were encouraged to use telemedical services to evaluate and continue opioid prescriptions. This proved to effectively address pain therapy gaps and has continued to be followed in palliation.

Overall, the recommendations for pain therapy during the covid era and thereafter involves making adjustments to the patient care model and correctly triaging the patients using strong pain evaluations.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

Meena Iyer A 3rd-year MBBS student at JSS Medical College, Mysore.

Enjoys playing Basketball and running long distances.

Also enjoys theatre and poetry.

College Sports Fest; the poster on the noticeboard reads. 2 years ago these exact words would have sent an excited tingle down my spine, but now it comes with more uncertainty than excitement and the anticipation teeter on the side of fear.

Let alone touching a basketball, putting on sports shoes was a rare occurrence in the past 2 years, I am not ready for a tournament! Will my shorts even fit me?

But alas the fire of a sportsperson never dies and we begin to practice the next day, although we are a little rusty in the beginning, I was confident that with a bit of practice we can put up a good show. This confidence and perseverance are the 2 biggest things sports instilled in me.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

Sports had taken such a huge hit during the pandemic because it was impractical to play with social distancing or with a mask on. But there was an increased enthusiasm for sports after the pandemic ended. People who rarely ventured out of their room saw it as a way to meet new people and get some fresh air and those who already played sports began coming to the field religiously. The way sports integrate mind and body exercise while being fun at the same time is unparalleled. No matter how tiring a day you have, especially as a medical student, an hour of football, badminton, basketball or any sport for that matter can wash away the fatigue, yes its paradoxical, but in the field of medicine paradoxes abound, so why not add this to the mix.

Playing a sport also allows you to meet new people, and forge bonds outside the classroom,with people from diverse backgrounds. It brings people together like nothing else, holding your breath while the ball slowly revolves around the rim, praying that it will go inside the basket, or anxiously watching your teammate run towards the ball before taking a penalty these are unexplainable emotions that only sports can consistently deliver.

During the pandemic, people realized what a valuable addition to their live sports was or could have been, and once lockdowns were lifted, teenagers and adults alike began to try their hand at a new sport. Post pandemic, it took a while for teams to get back into the groove, for each individual to get their fitness back up after a 2-year hiatus, and to regain coordination among players. In addition, junior players had to learn to step up to take the role of senior members of the team.

Newbies to the team had to learn the ropes pretty quickly to make up for the lost time. Yet teams and individuals picked up the pace, spent a bit more time on the field and polished their skills.

They didn't seem to mind the heat as they practised in the peak of summer, but then again what is a sport without its fair share of sweaty T-shirts and chugged water bottles.

The pandemic did nothing but dampen people;s enthusiasm for sports with overflowing bleachers and stadiums filled becoming more commonplace after the pandemic.

All in all the pandemic was a blessing in disguise for sports, as it bounced back harder than before with increased enthusiasm and fervour.

NEMO MALUS FELIX

Praveen Bharath S An enthusiastic final year student from KAP Viswanatham Government Medical College, Trichy.

Enjoys writing as a passion along with an occasional KPOP escapade. His interests include Addiction and Sleep Medicine.

Currently, he’s trying his hand at research and can often be found lurking on LinkedIn

According to Lazarus and Folkman, "coping can be understood as a constant cognitive and behavioural attempt to deal with specific external and internal demands that are perceived and valued as stressful." They have grouped them into functional (good) and dysfunctional (bad) coping strategies. Strategies that help in reducing the probability of suffering are functional coping. The ones that increase the same are dysfunctional coping.

Seeking support from friends, family and colleagues.

Relaxing exercises/sports.

Reading books Cooking, Baking Praying, Religious Practices Theatre/cultural events Practising music Going for a walk

Tranquillizers Stimulants Alcohol Withdrawal and ruminating Binge eating Impulsive Shopping Every dysfunctional coping strategy has its downfalls. Students abuse substances to cope with stress, anxiety, isolation, depression and job pressure.

Alcohol, cigarette, cannabis, bhang, tobacco chewing, etc on Indian academic and resident premises are found easily.

An individual who is abusing drugs may have a lower quality of Life.

Their risks include, Higher rates of co-morbidity Memory loss Missing classes, deadlines Lower academic performance Cognitive deficits Driving under the influence Violence Suicidal ideation

Every year lakhs of students compete to get a place among the 80,000 or so MBBS seats in the country.

Fast forward 5-6 years , and now these same thousands of MBBS students compete for the even fewer PG seats available in the country. Add to this the perils of our reservation system, and what we have is a ruthless rat race with toxic rivalries.

Stress is thus synonymous with a medical student, accompanying them at every stage of college and career.

There are various types of stressors they deal with.

First are the situational stressors like excessive work load, sleep deprivation, information overload, hectic vivas and never-ending exams. Next come the personal stressors: interpersonal grudges, financial issues, relationships, isolation, often due to relocation away from family, and an overall lack of an emotional support system.

Then come the professional stressors.

Healthcare providers are expected to empathise with the emotional needs of the patient. They are expected to exhibit resourcefulness in extreme crisis situations.

“It is not stress that kills us, it is our reaction to it.” ~ Dr. Hans Selye

Being a witness to constant human suffering and death adds a huge mental burden. The entire hospital working environment remains forever shrouded with a cloud of negative vibes.

While students cope with stress in many ways, more often than not, they focus on avoidance through abuse– forgetting about the emotional trauma by engaging in substitute activities like alcohol consumption, smoking and use of psychoactive substances. These substances act on the neural circuitry of reward and pleasure, help better deal with stress and impart a feeling of well-being. Besides the known chronic health repercussions, such vices can lead to increased absenteeism from lectures, withdrawal from society ,violence and other sorts of anti-social behaviour.

A medical student is looked upon as a role model. Substance use by such students can mislead the general public into believing that drugs can be made a part of one’s lifestyle.

Moreover, such a predicament may further worsen the already ravaging mistrust and hatred the masses are developing towards healthcare professionals.

The use of drugs among medicos is a serious public health issue.It is essential that we develop support groups within every institute to help such students. May it be a batchmate, junior, senior or a faculty, having someone you can reach out to and share your emotions with plays a big role in reducing substance dependency. Such groups should not only raise awareness about the illeffects of substance abuse, but also serve as platforms where students learn to deal with day-to-day stresses through other productive coping mechanism which can be imbibed in their routines.

In conclusion, I aptly quote, “Life is 10% what happens to you, and 90% how you react to it”. Stress when dealt with correctly is known to improve self confidence and maturity and accelerate the acquisition of knowledge and skills. It is imperative that we teach out future healers the right way to react to stress.

Siddhant Govekar

2nd year MBBS student at AIIMS Rishikesh. Loves playing sports, having tried his hand at volleyball, shot put, discuss throw, football and many more. Has keen interest in graphic designing and coding. Learning is a life-long process and he does not shy away from learning new skills. Believesin keeping life simple and finding happiness in its little things.

AMSA INDIA’S

Events

THE MSFC UNIT OF AMSA INDIA BROUGHT TO YOU

TEAL THE MOMENT an online awareness session about cervical cancer.

Cervical cancer is a very debilitating disease that affects the life of many women. Whether it is the patient or their family members and friends, cervical cancer is a disease that requires The sessions covered essential topics immediate awareness. such asWhat is cervical cancer?

Risk factors and clinical features Screening methods Treatment and prognosis Certain interactive activities

Project Chalaang under PHRD of AMSA India celebrated the World Immunization Week from 24th to 30th April with a series of thrilling and impactful events.

With the ultimate goal of raising awareness on the importance of immunization, ‘Vaccine Jingles’ a slogan writing competition on the theme ‘Long Life for All’ was held.

Additionally, ‘Immunopedia’ a series of Q&As on immunization were shared on AMSA’s official Instagram.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

EAMSC 2022 ONLINE ACADEMIC COMPETITION EAMSC 2022- Online Academic Competition was organised by AMSA India in conjunction with AMSA Australia, AMSA Thailand and AMSA Singapore under the supervision of AMSA International.

The event consisted of a full day of social activities, networking, panel talks, academic quizzes, and critical appraisals of research posters.General delegates got a chance to fully immerse in the day’s activities.

Certificates of attendance were provided for all delegates. Further certificates were awarded for the best critical appraisals and highest mark on the academic quiz.

EAMSEP INDIA X TurkMSIC Ceppahpasa The European -Asian Medical Students Exchange Programme (EAMSEP) conducted an online conference from the 13th to the 17th of April 2022.The EAMSEP will lasted for 5 days, wherein the delegates got a chance to experience the rich culture and healthcare system of Turkey all from the comforts of their own home.

All delegates were awarded exchange certificates.

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

After the immense success of Med Decathlon 1.0, AMSA India’s Academic Council came back with Med Decathlon 2.0;

A National level Medicine quiz spanning over 10 days The event being a solo participation is to be held on Quizizz Mobile application for user convenience. 13th to 22nd May,10 whole days of exhilaration and information to be looked forward to, brought to you by AMSA India Exclusively.

AMSA-India in collaboration with Med Students Network organized a detailed lecture on “A Guide to CV and personal statements” on 23rd April 2022 by spokesperson Dr Cynthia Tan, a former IMG & current Anesthesiology resident in New Jersey, USA.

REVISTA MEDICOS : ISSUE 14

ASIAN MEDICAL STUDENTS’ ASSOCIATION, INDIA

Palliative Medicine MedMania in collaboration with AMSA India conducted an online webinar regarding the topic of palliative medicine on 19th February 2022.

Palliative Medicine is an approach that improves the quality of life for both patients who are suffering from life threatening chronic illnesses and reduce the stress on their families.

It's main motive is to relieve the patient from their pain and suffering, while also receiving medical care and treatment for their symptoms.

The chief speaker was DR.GAURAIYA CHINCHALKAR who gave the participants an understanding of this humane and holistic approach to patient care.

Participants were awarded with certificates.

AMCEA AMSEP India organised ASCEA: Annual Summit on Cultural and Academic Exchange for all AMSA chapters on Autism Spectrum Disorders on 7th and 8th May, 2022.

It was a 2 day academic and cultural extravaganza comprising of an impressive line of guest speakers, interviews, cultural exhibitions and an exclusive open mic night!

All proceedings of the open mic registration (1USD) were given to charity.

MEMO-O- MANIA AMSA India’s MFSC unit organized an online meme making competition on the topic Obstetrics and Gynecology. The meme entries were judged by Shruti Prabhu, Chair, MSFC Unit AMSA India and the Editorial and Design team of MSFC Unit AMSA. The winners were awarded certificates and a feature in MSFC Unit’s Newsletter.

PAPYRUS “Ethics is knowing the difference between what you have a right to do and what is right to do”

AMSA India's Bioethics Unit organized “Papyrus”: An abstract writing competition in February 2022. The aim was to present the members an opportunity to explore the grey areas in ethics in healthcare.

Certificates were given to the top 3 entries.

STS 101 - Short Term Studentship (ICMR) TEAM MERSA TEAM MERSA took a commendable initiative to discuss and clarify the proceedings of ICMR-STS program.

Held on January 22nd,major topics were discussed such as: Managing STS with academics Approaching seniors and mentors Common myths and misconceptions Guidelines on writing a decent but effective proposal The agenda was discussed upon Instagram Live and certain queries were taken up towards the end resulting in a fruitful yet extremely informative session

Cross the Stigma - Spread the Word MSFC UNIT The MSFC Unit of AMSA India proposed the aforementioned initiative in the form of a crossword puzzle series to spread awareness regarding the issues such as Cervical cancer,STDs and contraception.

The activity was made interactive by drafting as a crossword with one held on each day: Sexually transmitted diseases-21/01/22 Cervical Cancer-25/01/22 Contraception-30/01/22 The goal was not only to spread the word but also to remove the stigma attached to these while giving students the opportunity to learn and revise these topics in a more fun and interactive way.

Hansen’s Interrogation PHRD, P&P DEPARTMENTS On the occasion of World Leprosy Day, January 30th, Project Pact 2 Protect under the PHRD department and P&P department of AMSA India held a quiz on Leprosy on the mobile application Quizizz.

The two-step quiz included the themes central to the Leprosy Day such as: Leprosy and its prevention Public health measures New treatment protocols The quiz went on to prelims and final rounds and certificates were provided to all the participants.Such activities amplify our awareness regarding these prevalent diseases and participation in such activities also stimulates the bandwidth of our knowledge.

AMSEP-Thailand AMSEP India of AMSA India organised yet another unique virtual exchange program with students from AMSA Thailand on May 20th 2022. It spanned over a period of 5 days, where students exchanged ideas, experienced the rich culture of Thailand and peeked into their advancing healthcare system, all from the comforts of their home!

AMSEP INDIA X INDONESIA: MAJAPAHIT The long awaited AMSEP INDIA X INDONESIA: MAJAPAHIT was conducted from the 23rd to the 27th of March 2022.

This virtual exchange program which lasted for 5 days, wherein the participants got a chance to experience the rich culture and healthcare system of Indonesia all from the comforts of their own home!

All delegates received an exchange certificate.

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