International Journal of Medical Sciences and Education (IJMSE)
Vol. 4; Issue: 2 (April-June 2017) , Date of Publication: 01.07.2017
MBBS IST YEAR STUDENTS’ PERCEPTION OF ‘QUICK CASE STUDY’ IN PHYSIOLOGY DIDACTIC LECTURE VIS-À-VIS THEIR PERFORMANCE.
Shrikant Ashok Shete, Rakesh K. Karnani , Mohammad Hamid ,Sapna Kamdar
ABSTRACT
Objective: To evaluates usefulness of didactic lecture in understanding a particular topic in physiology, improving teacher-students interaction in the class and it`s effect on result of university examination. Material and Methods: A prospective study was conducted among 1st year MBBS students (n=113) at Jhalawar Medical College, Rajasthan. The Students were informed about new intervention and voluntary consent was obtained from students. After taking didactic lecture, specific questions (based on the case) were posed for students to answer. At the end of class, their answers were used to reinforce the concepts from the lecture material and the case study. Result: Out of 113 participant, most were of the opinion that a ‘Quick Case Study’ in didactic lecture was very useful in understanding a particular topic (95 %), helpful in relating the clinical condition to the basic mechanism (97 %) and led to better exchange of ideas and may help them to perform better in the final examination (91 %).Conclusion: A ‘Quick Case Study’ in didactic lecture was very useful in understanding a particular topic in MBBS Ist year students’. This method is also helpful in relating the clinical condition to the basic mechanism and led to better exchange of ideas and may help them to perform better in the final examination.
Key Words: Quick Case Study, Didactic lecture, Pedagogy.
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A COMPARATIVE STUDY OF HISTOPATHOLOGICAL CHANGES IN HUMAN PLACENTAE OF NORMOTENSIVE AND HYPERTENSIVE PREGNANCIES.
Pankaj Saini, Gyan Chand Agarwal, Jai Prakash Pankaj, Anjali Jain
ABSTRACT
Background: 5 to 10% of all pregnancies complicated by hypertensive disorders and have great contribution to maternal morbidity and mortality. When maternal health is affected by a medical problem like, hypertension it may also affect the architecture and functions of the placenta. The placenta plays a role of bridge between mother and fetus and considered as a window through which maternal dysfunctions and their impacts on fetal well being can be understood. Aim and Objective: To compare histopathological changes in placentae of normal and hypertensive pregnancies. Material and methods: 40 placentae were taken from full term pregnant women who had clinically diagnosed hypertension during pregnancy and an equal number of controls were taken. Various histopathological changes in placentae of both groups were recorded and analysed using unpaired‘t’ test. Results: The study showed significantly excessive (p < 0.01) syncytial knots, fibrinoid necrosis, villous stromal fibrosis and cytotrophoblastic proliferation in placentae of hypertensive mothers as compared to controls while incidence of vasculo-syncytial membranes of the villi were found significantly less (p < 0.01) in placentae of hypertensive mothers. Conclusion: Placentae of hypertensive pregnancies showed significant histopathological changes as compared to controls that can be associated with impaired function of placenta, leading to adverse perinatal outcome.
Key words: hypertensive pregnancies, normotensive pregnancies, histopathological changes, placentae, pregnancy.
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SERUM COPPER LEVEL AS A MARKER OF PLACENTAL FUNNCTION
Mohini Nainani
ABSTRACT
Background: The foeto-placental transport system leads to higher transport of copper towards the increasing age of gestation. Copper is not only vital micro-nutrient but also notable value during pregnancy either normal or abnormal pregnancy. This study is planned to assess the serum copper levels as a marker of placental sufficiency. Material and Methods: Cross sectional study conducted at SRG hospital, Jhalawar medical college during the period of July 2016 to December 2016. 100 Patients of present study were selected from outdoor, antenatal clinic and from ward by simple random sampling. Blood sample for data collection obtained after general physical and systemic examination along with detailed menstrual and obstetric history after taking consent. Results: Serum Copper level estimation was done in 100 cases. Out of them 50 were non-pregnant and 50 were pregnant women. Among non-pregnant women average serum copper level was121 ± 4.82 μg/dL and in pregnant women it was found to be 245.08 ± 32.9μg/dL. This difference was statistically significant (P value < 0.001). The average serum copper levels in I, II and III trimesters were 183 ± 4.52, 251.5± 3.29, 271.5± 5.68 and this difference was found to be statistically significant (P value < 0.001). Conclusions: We draw the inference that these serum copper values can be implemented as an notable indicator of the condition foeto-placental unit, and should be introduced into the protocol of routine antenatal diagnostics as a simple, easy and accurate method by which we can quickly determine the functional condition of placenta and fetus.
Key words: serum copper, placenta, pregnancy.
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COMPARATIVE STUDY OF TOPICAL APPLICATION OF NANO SILVER AND POVIDONE IODINE DRESSING ON ULCER HEALING
Chandra Mauli Vyas, Mohd. Abbas Ali
ABSTRACT
Background: Treatment of ulcers stays a constant surgical and medical challenge. Present study was conducted to know the efficacy of Nano silver dressings versus Povidone iodine dressings for wound healing. Material & Methods: The present study was prospective comparative interventional study. 100 Patients of ulcer were selected from outdoor. The patients randomized into 2 groups- 50 in the Povidone iodine dressing group and 50 in the Nano silver dressing group. Results: Out of 100 Maximum patients were in the age group of 41-60 years, Both the dressing groups were statistically similar (p value = 00.551) for age and (p value = 0.248) for gender wise distribution. After the day 1 and the end of 1st week we got statistically non-significant results between both groups (p value > 0.05) in appearance of granulation tissue. But this difference was highly statistically significant (p value <0.001) at the end of 2nd, 3rd,4th and 5th week, faster appearance of healthy granulation tissue was seen in the Nano Silver topical gel group patients. At the end of 6th week, all patients in either group had no slough and had healthy granulation tissue. (p value <0.001). Conclusions: In present study there is very promising results shown in terms of rapidity of healing, removal of slough and also complete healing by topical Nano silver gel. Hence, we conclude that Nano Silver should be considered as a better option in contrast to Povidone iodine in safe and rapid management of patients with ulcer.
Key words: ulcer, healing, nano silver, povidone iodine.
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A CROSS SECTIONAL STUDY OF KNOWLEDGE AND PRACTICES OF ADOLESCENT FEMALES DURING MENSTRUATION IN UMRADA VILLAGE IN SOUTH RAJASTHAN
Dr. Abha Gupta
ABSTRACT
Background: Background: The onset of menstruation is an important physiological change in adolescent girls. Menstruation is a sensitive and private subject, with long term implications on a woman’s life, reproductive and otherwise. The following study was conducted with the objective of studying the behavior and patterns of menstruation during and immediately after menarche, and practices of menstrual hygiene among adolescent girls in Umrada village of South Rajasthan. Methods: The study was a community based cross sectional study that was done on a total of 459 girls, from the age group of 9 years to 14 years using a pretested semi structured questionnaire. Consent was taken from the ethics committee of the institute. Statistical analysis was done. Results: 338 girls out of 459 (73.71%) attained menarche between 12 to 14 years of age. 354 (77.16%) girls had a cycle that lasted 3-5 days, and 313 (68.19%) girls had a cycle every 28-32 days. 263 (57.28%) girls had absolutely no awareness about menstrual cycle before they achieved it. The most common source of information was found to be mothers (42.72%).150 girls (32.78%) girls exclusively used old clothes to the soak the bleeding. Various social restrictions are placed on menstruating women. Conclusion: The status of young adolescent females in the Umrada village of Rajasthan needs vast improvements in terms of knowledge and awareness about menarche, and other aspects of menstruation. Also, sanitary napkins should be made easily available to decrease their reliability on cloth. Education of the community as a whole can help fight the taboo against menstruation.
Key Words: Menstruation, Menarche, Sanitary napkin, Adolescence
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CASE BASED VERSUS DIDACTIC LECTURE FOR EFFECTIVE LEARNING BIOCHEMISTRY IN FIRST MBBS
Dr Boinapalli Sudhakar, Mr Ajay, Dr AP Gupta
ABSTRACT
Background: There are no effective Teaching-Learning methods for Biochemical basis of disease and Metabolic pathways in first MBBS. Objectives: To compare case method with didactic lecture. To evaluate students performance and satisfaction by case based method. Methods: Departmental meeting was conducted to select 3 topics and plan the session. IEC approval was obtained. I MBBS students (117) were first taught on one topic (lipid metabolism) by didactic method and then 2 topics by case based method (CBM). CBM-1 (protein metabolism) was attended by 113 and CBM-2 (Carbohydrate Metabolism) by 126 students. Pre and post test conducted at the end of each session with case based MCQs and short answers. Results: An imperative progress (Z>1.95, Z>2.95, p<0.001)) was observed among the students performance after the CBM sessions compared with didactic method. A 5 point summative scale questionnaire was administered to the students, to know their perception on usefulness of CBM. Nearly 87.3 % of students felt that the CBM sessions stimulated their interest in Biochemistry subject. Out of the total 239 responses 232 (97.0%) responses liked session, where 7 (3%) did not like the session. Conclusion: We conclude that the innovative Case Based learning method superior than didactic method. CBM increased performance and satisfaction of I MBBS students.
Key words: Institutional ethics committee (IEC), Case based method (CBM).
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EFFECTIVENESS OF MANNHEIM PERITONITIS INDEX IN PREDICTING THE MORBIDITY AND MORTALITY OF PATIENTS WITH HOLLOW VISCOUS PERFORATION
Dr Vinod Kumar, Dr Anil S.P, Dr Vandna Yadav
ABSTRACT
Background: Mannheim peritonitis Index is among many scoring system that provides objective descriptions of patient’s condition at specific point in the disease process. This study aims to evaluate the validity of Mannheim peritonitis index scoring system and the various prognostic factors which determine the outcome of the disease. Materials and method: This study, carried out at the Department of Surgery at R.N.T. Medical College, Udaipur. Diagnosis were made by history and clinical examination, x-ray chest PA view and confirmed by exploratory laprotomy. Patient with perforation due to trauma and have other significant illness which is likely to affect the outcome is excluded. Results: In this study 50 cases of hollow viscous perforation were selected over a period of one year(2014).Mean age of patients were 48.94 years, most of patients, 31 (62%) belong to age group of 31-60 years (range 18-85) with male preponderance 40(80%). Majority of patient 36(72%) presented to hospital after 24 hrs of onset of symptoms and the mortality of those patient who presented within 2 to 5 days and after 5 days was 23.3%(7) and 33.3(2) respectively as compared to 8.2%(2) in patient who presented within 24 hrs. Out of 50 patients 36%(18) had MPI score<21, 40%(20) had MPI score 21-29 and 24%(12) had MPI score>29 morbidity and mortality rate were 11.1%(2) and 0%, 45%(9) and 15%(3), 33.3%(4) and 66.7%(8) respectively. Out of 50 patient duodenal perforation was seen in 56%(28), gastric in 24%(12),ileal in 14%(7),colonic in 4%(2) and appendicular perforation in 2%(1).Conclusion: Delay in surgical intervention is associated with morbidity and mortality. In the management of patient with generalized peritonitis scoring system is beneficial. MPI scoring system easy to scores and to apply.
Key Words: Mannheim Peritonitis Index, Perforation peritonitis.
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EFFECT OF COMPLETE MIND-BODY THERAPY ON PULMONARY FUNCTION TEST IN ASTHMA PATIENTS ATTENDING OPD OF SMS HOSPITAL, JAIPUR.
Dr. Ruchi Goyal, Dr. Meenakshi Sharma, Dr. Ram Babu Sharma, Dr. Ajeet Singh Shaktawat
ABSTRACT
Background: Asthma is becoming a substantial burden to people causing a reduced quality of life due to physical, psychological and social effects. Yoga is considered best complementary and alternative medicine by the National Institutes of Health. The aim of our study is to see the effect of yoga in asthma patients in and around Jaipur city. Materials and Methods- The study was conducted on 108 stable diagnosed bronchial asthma patients randomly divided in study and control group (54 in each group of 18 to 40 years of age) of either sex. The study group was given yoga practice (asana, pranayaam, cleansing technique and meditation) for 8 weeks under the guidance of trained yoga instructor and asked to continue their medication. The pulmonary function test (FVC, FEV1, FVC/FEV1 ratio, PEFR and FEF 25-75%) was recorded at baseline and after 8 weeks of duration. The paired‘t’ test and unpaired‘t’ test was used for data analysis. Results- There was statistically significant improvement (P<0.001) in PFT parameters(forced vital capacity (FVC), forced expiratory volume in 1st sec (FEV1), FEV1/FVC ratio, peak expiratory flow rate (PEFR) and FEF(25-75%) after 8 weeks of yoga practices in study group but no significant improvement in control group. Conclusion- The present study demonstrated that complete mind body approach with regular asana, pranayaam, cleansing technique and meditation lead to significant improvement in pulmonary function in bronchial asthma patients and acts as additive effect in treatment of asthma along with medication.
Key words. Yoga, Asthma, Pulmonary function test.
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THE PATTERN OF SUBSTANCE USE IN ADMITTED PSYCHIATRIC PATIENTS
Dr. Suresh Gocher, Dr. Puranmal Verma, Dr. Lalchand Bairwa, Dr. Bhagyashree Garasia, Dr. Sunil Kumar Sharma,Dr. Amrit Gosai.
ABSTRACT
Background: Substance abuse is very common problem in Psychiatric Patients. This study asses the Pattern of substance use among the admitted psychiatric patients in Department of psychiatric RNT medical college, Udaipur. Method: Pattern of Substance use were assessed from 1st June 2014 to 31st August 2014 admitted in psychiatric dept.(n=502) using the ICD-10 criteria for diagnosis. Results: Most patients belong to low socioeconomic status, education up to primary level. 80% patients were suffering from schizophrenic and bipolar illness. 80% of male and 23% of females were using substance. Most commonly Tobacco, alcohol and cannabis. Conclusion: Majority of subjects belongs to low socioeconomic status, about ¾ of subjects were schizophrenic and bipolar. Most common substance use was tobacco followed by alcohol in males and opium in females.
KEYWORDS: substance use; low socioeconomic status, tobacco.
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A CORELATIVE STUDY OF THYROID FUNCTION IN DIABETES MELLITUS IN HADOTI REGION OF RAJASTHAN
Dr. Mayank Nama, Ajay Kumar Bhargava
ABSTRACT
Background: This study compare thyroid hormone (T3, T4, TSH) levels among diabetic and non-diabetic subjects and investigate the effect of diabetes mellitus on thyroid hormone levels in diabetic patients. The present study also enumerates the prevalence of abnormal thyroid hormone levels in diabetes mellitus. Material and Methods: We have determined the incidence of abnormal thyroid hormone levels in diabetics, fasting blood samples from 40 diabetic subjects and 40 non-diabetic controls were analyzed. Results: Out of 40 cases maximum, 72.50% had serum T3 level within the normal range of 0.7-2.0 ug/d1, 62.50% had serum T4 level within the normal range of 5.5-13.5 ug/dl and maximum 75.00% had serum TSH level within the range of 0.3-6.5 u IU/ml. Out of 40 controls; 90.00% had serum T3 level within the range of 0.7-2.0 ng/dl, 65.00% had serum T4 level within the range of 5.5-13.5 ug/dl and 80.00% had serum TSH level within the range of 0.3-6.5 u IU/ml. The significance of difference between case sample mean and control sample mean regarding Serum T3, T4 and TSH values in these 2 populations; the difference between two sample means was statistically not significant in case of serum T3 values (P>0.05) whereas it was statistically highly significant in case of serum T4 values (P<0.001) and statistically significant in case of serum TSH values (P<0.01). Conclusion: These findings demonstrate that detection of abnormal thyroid hormone levels in the early stage of diabetes will help patients improve their health and reduce their morbidity rate. Thus routine assessment of thyroid hormone levels should be recommended in diabetics.
Keywords: Blood sugar level, thyroid dysfunction, subclinical hyperthyroidism
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THE EFFICACY OF FENTANYL AND CLONIDINE AS AN ADJUNCT TO LOCAL ANAESTHETICS IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: RANDOMIZED DOUBLE-BLIND CONTROLLED STUDY
Dr. Brajesh Kumar Ratre, Dr. Vandana Mangal, Dr. Gaurav Sharma, Dr. Neena Rungta, Dr. Santosh Choudhary, Dr. Vishnu Kumar Garg
ABSTRACT
Background: This study was designed to assess the effects of fentanyl and clonidine on the onset of sensory and motor block, intra-operative hemodynamic changes and postoperative analgesia during supraclavicular brachial plexus block. Method: 135 adult ASA physical status I and II, scheduled for elective hand and upper limb surgeries were randomly allocated to three groups by using chit in a box method. Group I received 0.25% bupivacaine 20 ml and 1.2% lignocaine 10 ml, group II received equal volume of 0.25% bupivacaine and 1.2% lignocaine with fentanyl 50 microgram and group III received equal volume of 0.25% bupivacaine and 1.2% lignocaine with clonidine 75 microgram. The supraclavicular block was performed by paresthesia technique. Patients were observed for onset and duration of sensory and motor block, duration of analgesia, hemodynamic variation, postoperative pain and side effect. Result: The addition of both fentanyl and clonidine to bupivacaine lignocaine mixture decreases the onset time of sensory block (p<0.05). The duration of both sensory block and motor block was significantly prolonged in fentanyl (p < 0.001) as well as clonidine (p < 0.001) groups. The mean duration of analgesia in control was 256.78±41.288 (min), in fentanyl 455.44±75.301 and clonidine was 619.33±72.344 (min).The p-value was <0.001 between the Groups and found to be statistically significant. Conclusions: We concluded that the addition of 50 microgram fentanyl or 75 micrograms of clonidine in local anaesthetic solution in supraclavicular brachial plexus block prolongs the duration of the block and postoperative analgesia and clonidine is more significantly prolongs than fentanyl.
Keywords: supraclavicular block, fentanyl, clonidine
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COMPARISON OF NON STRESS TEST AND UMBILICAL ARTERY DOPPLER IN HIGH-RISK PREGNANCY
Nooren Mirza, Veena Meena, Reinu Garg, Vineeta Gupta, Rabinder Iqbal, Kiran Meena, Neha Agarwal,
Shivani Gupta
ABSTRACT
Background: The study aimed to compare the screening ability of two different modes of the antepartum fetal testing i.e. Non stress test and umbilical artery Doppler for the presence of peripartum morbidity, as measured by the cesarean delivery rate for fetal distress. Materials and Methods: A total 100 women with high risk pregnancy of gestational age >32 weeks attending the ANC of a tertiary health centre were enrolled in the study. Antepartum fetal surveillance of these women was done by either non stress test or umbilical artery Doppler velocimetry alternately. If either of these tests was normal, patients were screened with the same method as per the study protocol. If abnormal results were obtained, induction and delivery were recommended within next 24 hours. Statistical comparisons were done with the X2 test. Results: 73.52% women with a reactive NST had vaginal delivery while 67.85% of women with normal S/D ratio had vaginal delivery. Out of the total 31 women who had fetal distress in labor, 17 belonged to the NST groups and 14 to the Doppler group of the total cesareans done in the NST and Doppler group were 63.63% and 50% respectively for fetal distress. The probability of having fetal distress in the Doppler group is 0.823 times that of the NST group. Conclusion: Umbilical artery Doppler stands out as a better screening test for high risk pregnancies as the proportion of having fetal distress in labor is less than that of NST.
KEYWORDS: Doppler velocimetry, High risk pregnancy, Non stress test
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CLINICO-MORPHOLOGICAL SPECTRUM OF CARCINOMA BREAST AT A TERTIARY CARE HOSPITAL IN SOUTH RAJASTHAN, INDIA
Dr. Sonal Agarwal
ABSTRACT
Background: Breast cancer is the leading cause of cancer death in women worldwide. Breast cancer being one of the most dreaded diseases with uncertain cause has gained concern of surgeons and scientific fraternity worldwide. The rates of breast cancer vary amongst men and women of different ages and ethnicities. Our study aims at analysis of cases of carcinoma of breast, study of various histological subtypes and assessment of histological grading of tumor. Materials and methods: This prospective and retrospective clinicopathologic study was conducted on 58 patients of Breast Carcinoma at pathology department of Pacific Medical college and hospital, Udaipur. Clinical details were recorded and complete histopathological examination of specimens was done. Results: Of the patients of age group 31-84 years, breast carcinoma was most common (37.84%) amongst females of 41-50 years. Females (96.55%) outnumbered males (3.44%) for the disease. The site of breast carcinoma was found to be upper outer quadrant in significantly higher number of cases (65.2%). There was a predominance of Invasive duct carcinoma of NST type (79.3%). Histologically grade III carcinoma (75%) was found to be leading other grades. Conclusion: Invasive duct carcinoma is the commonest type of breast carcinoma which was most commonly seen in upper outer quadrant of the breast. Histologically grade III carcinoma was found to be predominant. Maximum number of these tumours was encountered in the fourth decade of life of females. Histopathology plays an important role in the diagnosis of breast diseases. There is a necessity of Breast examination awareness'.
KEYWORDS: carcinoma breast, invasive duct carcinoma
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TO STUDY THE SOCIO-CULTURAL FACTORS AND OTHER FACTORS INFLUENCING INITIATION AND DURATION OF BREAST FEEDING AT JAIPUR
Dr. Ishaan Kalavatia, Dr. Veerbhan Singh, Dr. S L Bhardwaj
ABSTRACT
Background: Study of the socio-economic aspects affecting initiation and duration of breast feeding. Material and methods: A cross-sectional study included 400 mothers both literate and illiterate and their infants living in the rural area of Jaipur. Data collected was based on occupation, socio-economic status, literacy status and type of work, type of family, residential environment, life-style and analysed likewise. Results: Classification on the basis of socio-economic status, maximum mothers belongs to class III category i.e. 38.75%. Education wise, 37% mothers were illiterate and 63 % were belongs to educated category. Conclusion: Reason of maximum of health problems in the survey area were related to the malnutrition along with infective diseases which are associated with socioeconomic factors involves mother’s illiteracy, family income, mother working conditions and socio- economic status.
Keywords: Literacy, Socio-economic aspects, breast feeding practice, occupation.
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ASSESSMENT OF CLINICAL PROFILE OF MELASMA AMONG PATIENTS VISITING TERTIARY CARE CENTER
Dr. Gajanand Ojha, Dr. Kishor Singh
ABSTRACT
Background: Melasma is a chronic and recurrent disorder which has been under-diagnosed for decades and is under-treated due to lack of effective definitive therapies and the perception that it is merely a cosmetic nuisance and nothing much except hyper pigmentation. Material & Methods: The present cross-sectional prospective study was conducted at department of dermatology of our tertiary care hospital. Patients of all 3 types of melasma attending the outpatient department of dermatology were selected irrespective of age, sex, duration and previous therapy. Results: Malar region was the commonest affected area found in 84% patients followed by Centro-facial in 53% and least involvement was seen in forehead region in 39% patients. On Wood's lamp examination 64% patients had epidermal type of pigmentation, 23% patients had mixed type of pigmentation and only 17% patients had dermal pigmentation. 36% patients reported association of occurrence of the lesions with pregnancy, 16% patients reported sunlight to be the offending agent, 9% patients were habitual of working on computers and in 3% cases there was history of application of some cream / lotion. Conclusion: Females were affected more commonly during their late third decade of life. Although we did not find the exact cause of melasma, we noticed that sun-exposure, pregnancy, and taking of oral contraceptive pills could precipitate or exacerbate the melasma.
Key words: Melasma, Pregnancy, clinical profile.
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