Volume 5 Issue 1

International Journal of Medical Sciences and Education (IJMSE)
Vol. 5; Issue: 1 (Jan-March 2018), Date of Publication: 01.04.2018

Table of Contents

1. Editorial- THE PLAGIARISM OR ACADEMIC POLLUTION 1
PDF FULL TEXT

2. SPECTRUM OF HEPATIC INVOLVEMENT IN PATIENTS WITH DENGUE INFECTION 2-6
Dr. Virendra Goyal, Dr. Asrar Ahmed PDF FULL TEXT

ABSTRACT

Background: dengue infection is a public health situation which requiring immediate action because of its capacity to metastasize exponentially beyond geographical borders. There are around more than 50 million new dengue infections encountered each year all around the globe. Material & Methods: The present study was a retrospective observational type study which includes 100 patients of dengue which were serologically proven and who were admitted at American international institute of medical sciences, GBH Hospital, Bedwas, Udaipur, Rajasthan. The study was conducted from May 2017 to October 2017. Results: Out of total 100 patients, 37 had less than 2 fold raised titer of ALT levels, 20 had 2-4 folds raised ALT levels, 21 had 4-10 folds raised ALT levels and 10 had more than 10 fold raised ALT levels. 9 had normal titer of AST values, 25 had less than 2 fold titer normal AST values, 24 had 2-4 fold raised AST titer than normal values, 28 had 4-10 fold raised AST values and 14 had greater than 10 fold raised AST values than normal range. Bilirubin levels were elevated in 10 patients, alkaline phosphatase levels were elevated in 29%, and serum globulins were elevated in 11 patients. Serum proteins were below normal range in 46% and serum albumin was below normal in 35% of patients. Conclusion: We concluded that range of liver function deterioration in dengue fever can vary from asymptomatic to symptomatic biochemical involvement and beyond to severe acute liver cell injury. Low serum albumin levels observed which can be used as marker of the critical phase of the liver disease.
Key words: ALT, AST, Dengue fever, Hyperbilirubinemia

3. CLINICAL PROFILE EVALUATION OF FEBRILE THROMBOCYTOPENIA 7-11
Dr. Mridul Bhushan, Dr.Prem Singh PDF FULL TEXT

ABSTRACT

Background: Thrombocytopenia is multifactorial and can be present in many diseases but still it can be fatal. The platelet count less than 1,50,000/μL characterized as thrombocytopenia. The most common etiology behind this in febrile cases are expanded sequestration in spleen, diminished creation and expanded obliteration. Material & Methods: In present study 100 patients of more than 12 years of age having fever as presenting symptom with thrombocytopenia were included in the study after obtaining approval from the institutional ethics committee. Patients having a febrile thrombocytopenia and congenital thrombocytopenia were excluded from the study. Results : 26% cases were due to viral fever while 29% cases were due to malaria, 27% cases had dengue fever and 12% cases had septicemia while leptospirosis and scrub typhus accounts for 6% cases collectively. In sixty percent of the cases, platelet count was between 50000 to 100000 per cubic mm. Headache was present in 72% cases, Myalgia was seen in 65 percent of the cases, Chills and rigors are seen in 60% cases of febrile thrombocytopenia. Bleeding and rashes were present in 13% and 21% cases respectively. Conclusion: We concluded Based on the results of present study that, infectious diseases accounts for most of the cases of febrile thrombocytopenia and out of them malaria and dengue were the most common cause
Key words : Febrile, Fever, Thrombocytopenia.

4. SEROPOSITIVITY OF DENGUE VIRUS AND COMPARISON OF DENGUE IGM RAPID CARD 12-17
SEROREACTIVE TEST WITH DENGUE IGM ELISA : A STUDY AT A TERTIARY CARE HOSPITAL,
UDAIPUR, RAJASTHAN
Dr. Anshu Sharma, Dr. Pawan Kumar Avasthi , Deepa Upadhyay PDF FULL TEXT

ABSTRACT

Background: Dengue virus infection is one of the major public health problems and a major constituent of emerging infectious diseases worldwide. Objectives: To study the Seropositivity of Dengue Virus and comparison of Dengue IgM Rapid Card Test Seroreactive Test with Dengue IgM ELISA. Materials and Methods: 23820serum samples from patients with febrile illness attending to the inpatient and outpatient department were processed by Dengue Rapid card test and then 312 IgM seroreactive sample processed by Dengue IgM Capture ELISA for confirm. Results: Out of 23820 serum samples, sero-positivity for DEN V was found in 312 (1.30%). In which 230 (0.96%) were IgM Positive and 82 (0.34%) were IgM,+ IgG Positive and 23506 (98.69%) were found sero negative for DEN V by Dengue IgM and IgM+IgG Rapid Card Test, period out of 312 total serum positive samples 195 (62.50%) were males and 117 (37.50%) were females. Most affected age group from febrile illness is 11-20 years (27.05%), followed by age group 21-30 years (24.03%. Maximum seropositive samples were in month of October 69(39.42%), and then in November 44(25.14%) and in September 40(22.85%) were come out. Out of 312 Positive Rapid card test only 136 [43.59%] was positive for DEN IgM Capture ELISA which is gold standard test for Dengue disease. Conclusion: Early diagnosis and treatment of Dengue virus infection is important for patient and community. It is need of continuous surveillance for Dengue virus disease using multiple diagnostic tests. In Indian setting screening of Dengue virus by Rapid Card test is necessary.

KEYWORDS: Dengue Virus, ELISA.

5. A GAME BASED LEARNING ACTIVITY IN CLASSROOM ON G PROTEIN SIGNALLING 17-22
AMONG FIRST YEAR MEDICAL STUDENTS
Dr. Tandra Ghosh, Miss. Suchitra Dutta PDF FULL TEXT

ABSTRACT

Background: Due to vastly diverse and complex nature of information which are to be acquired during medical degree studies, as it possesses an utmost challenge both for the learners as well as the educators to excel in effective teaching and learning. But it is beyond doubt that, students should be taught with active and sustainable learning strategies at each step of medical study period. The irony is still exist as the most widely practice method is didactic form of teaching in classroom which provide with very minimum scope of eliciting effectiveness of productive teaching or student learning. To diversify the teaching repertoires beyond traditional didactics, one form that is gaining momentum, is the use of educational games, which is presently practiced minimally for class room teaching. Method: the attempts have been undertaken to elicit the effectiveness of teaching strategies by combining educational game with didactic lecture in classroom to impart target knowledge regarding G protein signalling process, using interactive non-competitive, educational puzzle in small peer groups with didactic lecture sessions. Result: The result/ outcome reflected in this process that the game was more beneficial than didactic lecture alone to the students in classroom. Seventy five students (75) out of total eighty four students (84) has reported the that the learning experience by the game based activity has helped in better understanding of the topic than didactic lecture alone. Conclusion: Imparting the knowledge involving educational games can better ensure active student participation and resulting in more effective understanding as well as developing a growth mindset.

KEY WORDS : Medical education, Game and learning in Classroom.

6.   PRIMARY PREVENTION OF CORONARY HEART DISEASE (CHD) IN SAUDI ARABIA:   23-29
    MEETING THE CHALLENGE
  Dr. Homaidan T. Alhomaidan PDF FULL TEXT

ABSTRACT

Coronary heart disease (CHD) represents the third most common cause of hospital-based mortality. Many studies have identified that diabetes, dyslipidemia, hypertension, obesity, smoking, lack of physical activity, unhealthy diet, and excessive alcohol consumption are the main risk factors associated with myocardial infarction. Primary prevention of CHD includes delaying or limiting the first changes in individuals who have not yet been diagnosed with a heart disease or being aware of potential heart illness, while secondary prevention aims to prevent, postpone, or limit the progression or the recurrence of the clinical manifestations of CHD in patients who have already been diagnosed with CHD. Identifying individuals with cardiovascular risk factors through screening allows for additional evaluation, diagnosis, and treatment. Several studies have compared the outcomes of when care is given to high-risk individuals with poor lifestyle to the care given to the entire population, addressing the environmental and behavioral characteristics of the population in general. However, if the recent increase in the incidence of obesity, diabetes, and smoking continues, Saudi Arabia will face major challenges to lowering cardiovascular risk factors in the population, and the end of this epidemic will not be in sight. This review draws attention to possible prevention modalities to address this important public health problem.

KEYWORDS : Coronary Heart Disease, Prevention, Saudi Arabia.

7. LECTURING IN MEDICINE : THE INTERACTIVE WAY 30-36
Dr. Sameer. M .Khan, Dr. Anisa Khan PDF FULL TEXT

ABSTRACT

Background: Interactive lecturing involves an increased interaction between the teachers, students and the lecture content. The use of interactive lectures can promote active learning, heighten attention and motivation, give feedback to the teacher and the student, and increase satisfaction for both. This article describes a number of interactive techniques that can be used in large group presentations as well as general strategies that can promote interactivity during lectures. The aim of this article is to describe the advantages and indications for interactive lectures, to discuss common fears and concerns about using this method of teaching, to outline a number of interactive techniques that can be incorporated into medical teaching at all levels, and to highlight general guidelines for successful interaction and audience participation. Materials and Methods : The data from various journals and other sources were collected regarding the techniques used in lecturing in medicine and were thoroughly reviewed. Results: It was agreed that interactive lecture indeed has a lot of benefit to both the students and to the teachers Conclusion: It was concluded that in order to have an effective implementation of the interactive lecture the teacher should be willing to take risks, be thoroughly prepared and remain flexible.
KEYWORDS : Interactive Lecturing, feedback, heightens attention

8.  PATTERN OF UTILIZATION AND PERCEPTION OF MEDICAL UNDERGRADUATES    37-41
REGARDING OVER THE COUNTER DRUGS
  Lokendra Sharma, Kopal Sharma, Monica Jain, Rupa Kapadia,
Jyotsna Bhargava, Meenu Rani   PDF FULL TEXT

ABSTRACT

Background: Over the counter, drugs are used with increased propensity in medical undergraduates as they have some knowledge and good exposure to drugs. Assessment of the knowledge and perception of self-medication in them is extremely crucial as they are future prescribers of medicine. Material and Methods: A pre-tested and validated semi-structured questionnaire regarding the use of over the counter drugs was shared with 250 second year medical undergraduate students in the form of Google forms. The responses generated in MS Excel spreadsheets were tabulated and subjected to statistical analysis. Results: Among the respondents, 36% did not know what does over the counter drug mean. 90.8% of the respondents have used over the counter drugs. Most of the respondents have taken self-medication approximately three times on an average in last one year. Most common conditions/symptoms for self-medication were cough and cold (74.3%), pain (71.5%) followed by fever (61.5%) and diarrhea (28.89%). 15% of them experienced adverse reactions to self-medication with over the counter drugs. 58% followed the instructions as per Package Insert and 40% recommended the medicine to others with similar problem. Conclusion: Over the counter medication is extensively used among medical students. It is imperative to impart them better understanding about over the counter medications and their possible adverse effects during their phases of pharmacology learning itself.
KEY WORDS: Over the Counter drugs, Google forms, Self Medications, Medical Undergraduates

9. ASSESSMENT OF RISK FACTORS FOR ACUTE SEVERE ASTHMA IN CHILDREN 42-45
Dr. Ashok Kumar , Dr. Govardhan Meena, Dr. Ram singh, Dr. Rajesh Aggarwal PDF FULL TEXT

ABSTRACT

Background: The present study was planned and conducted to assess the risk factors responsible for acute severe asthma in children. Material & Methods: The present study was an observational cross-sectional study. A total of two hundred children of the age group of 5 to 18 years were included in the study after undertaking written informed consent. Children presenting with signs and symptoms of acute severe asthma as per Global Initiative for Asthma guidelines (GINA) were included in the study. Results: In the present study, a total of 200 children with presenting signs and symptoms of acute severe asthma were included. Majority of the children were among the age group of 5-10 years (n = 124; 62%), males were affected more than females in the ratio of 1.44: 1. Poor drug Compliance seen in (n = 134; 67%; p <0.001) and risk factor named exposure to house dust found among (n = 128; 64%; p <0.001) and risk associated with smoke exposure was demonstrated among (n = 91; 45.5%; p <0.001). The family history of asthma was positive in 64%, raised absolute eosinophil counts (>400 cells/μL) was observed in 68% of children. Conclusion: Acute severe asthma is a manageable and preventable emergency. The present study results had shown that poor drug compliance, acute reactions to house dust exposure and smoke exposure were found as the significant risk factors for acute severe asthma.
Keywords: Acute severe asthma, Children, Risk factors.

10.  PREDILECTION OF DEPRESSIVE DISORDER WITH IMMUNOLOGICAL   46-49
AND BIOCHEMICAL MARKERS
    Dr. Manisha Baraiya, Dr. Anita Sharma PDF FULL TEXT

ABSTRACT

Background: Depression is one of the most common mental disorders but serious illness. It started when you are a teen or child but it can happen at any age. Depressed people can feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, alone, irritable, hurt, or restless. Recent investigations reveal that cytokines are involved in not only inflammatory and infections CNS disease but also in the neurodegenerative diseases and in functional psychosis. Material and Method: Type of study: This was a cross sectional, observational, descriptive-analytic study Place of study: The study was conducted in a Tertiary Care Teaching Hospital Duration of study: 12 months, Sample size: 150, Total 150 participants were selected from both genders ranging in age between 20 to 60 years who were attending psychiatric O.P.D at tertiary health care Hospital, 50 control subjects were selected. Procedure: Approval from Institutional Ethics Committee was taken before starting the study. The study was explained to them in brief in a language they can understand. Consent of participants was taken in written informed consent form. All data collected were analyzed using appropriate statistical tests. Result: Analysis for comparison of means of clinical characteristics and laboratory parameters of patients revealed that association between depression disorder and IL-6,serum total cholesterol, serum-LDL and triglyceride was statistically significant (p<0.005)and there is some definite relationship between serum IL-6 , lipid profile and development of depression disorder.
Keyword: Depression, Lipid profile, Interlukin-6, magnesium.

11. A CLINICO-PATHOLOGICAL STUDY OF CO-RELATION BETWEEN ADENOID HYPERTROPHY 50-59
AND SINUSITIS IN CHILDREN WITH PERSISTENT RHINORRHOEA
Abhay Sharma, Pratibha Vyas, Navneeta Gangwar, Vaishali kataria,
Shruti Baruah, Arpit Srivastava PDF FULL TEXT

ABSTRACT

Background: This study was designed to study the clinicopathological study of co-relation between adenoid hypertrophy and sinusitis in children with persistent rhinorrhoea. Additionally, the association between exposure of passive smoking and adenoid hypertrophy, nasal allergy and adenoid hypertrophy and association of S. pneumoniae colonization and adenoid hypertrophy and incidence of otitis media in children with persistent rhinorrhoea was studied. Method: Children aged 1–14 years with persistent rhinorrhea underwent clinical evaluation, rigid nasal endoscopy and x-rays of the nasopharynx and paranasal sinuses to ascertain the presence of adenoid hypertrophy and sinusitis using standard criteria. Absolute eosinophil count, serum IgE level and skin prick test were performed in patients showing features of nasal allergy. Nasopharyngeal swabbing to confirm the presence of nasopharyngeal colonization with S. pneumoniae was also performed. Results: Adenoid hypertrophy was more consistently associated with persistent rhinorrhea than sinusitis (p < 0.0001). Coincident adenoid hypertrophy and sinusitis occurred in 57 %. S. pneumoniae was cultured in only 29 % of children. Up to 47 % of patients had features of nasal allergy. There was no association between S. pneumoniae colonization and adenoid hypertrophy (p = 0.1). Conclusion: Adenoid hypertrophy is an important cause of persistent rhinorrhea in children. S. pneumoniae colonization of the nasopharynx is not a major etiological factor for persistent rhinorrhoea in these children. Nasal allergy may be a cause of adenoid hypertrophy in roughly half the children. Children who were exposed to the passive smoking incidence of adenoid hypertrophy was more.
Keywords: Persistent rhinorrhoea Adenoid hypertrophy, Sinusitis, S. pneumoniae nasopharyngeal colonization. Passive smoking Skin prick test

12. ERO-PREVALENCE AND TRENDS OF TRANSFUSION TRANSMITTED INFECTIONS 60-67
AMONG 706853 BLOOD DONORS IN A TERTIARY CARE HOSPITAL IN JAIPUR
SARITA SHARMA, SUNITA BUNDAS, ASHOK PAL PDF FULL TEXT

ABSTRACT

Background: Transfusion Transmitted Infections (TTI) posses a great threat for the health and safety of patients. In order to provide safe and adequate quantity of blood and blood components, Govt. Of India made pretransfusion screening and testing mandatory in the National Blood Policy (2002). AIM : The aim of this study is to assess the trends and seroprevalence of TTI’s among voluntary and replacement donors in the north western region of Rajasthan. MATERIAL & METHOD: A retrospective review of donor’s record covering the period between 2002 to 2015 is carried out at Blood Bank, SMS Hospital, Jaipur. All samples were screened for HIV, HBV, HCV, Syphilis & Malarial parasite. Method used is ELISA (for HIV, HBV, & HCV; RPR for Syphilis and Random peripheral blood film examination/ rapid card test for malaria). RESULTS: Prevalence of TTI in total donors is 3.02%. Prevalence of Hep B (1.83%) was highest followed by Syphilis (0.75%), HCV (0.28%), HIV (0.15%) and Malaria (0.01%). CONCLUSION: It is important to analyze the incidence, prevalence and causes of TTI in our region & compare them with national & international level. It is well within the reach to reduce the incidence of TTI’s in Indian scenario with the implementation of strict donor criteria and use of sensitive screening tests.
KEY WORDS: Transfusion Transmitted Infection, Blood Transfusion, Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus, Syphilis, Malaria

13. ASSOCIATION OF DIABETES MELLITUS AND PERIODONTITIS 68-70
Dr. Rajmal Meena, Dr. Ajay Kumar Bhargava, Dr. Aparna Betharia PDF FULL TEXT

ABSTRACT

Background: Diabetes mellitus is a part of metabolic X syndrome, progression may be dangerous and its association with periodontal disease is important in diagnosis and medical management of both disease. Material and Method: In present study we have determined HbA1c and Glucose level in diabetes mellitus with periodontitis, diabetes mellitus without periodontitis and non-diabetes mellitus with non-periodontitis by commercial kit method on fully automated Beckmann coulter analyzer on cases coming to SRG hospital and Jhalawar Medical College, Jhalawar (Raj.). Results: we found in non-diabetes with non-periodontitis HbA1c level is 4.40+-1.10 and glucose 87.58+-2.12, in diabetes with periodontitis HbA1c is 6.89+-1.55 and glucose 132.30+-5.2, in non-diabetes with periodontitis HbA1c is 5.10+-1.20 and glucose is 92.72 +-3.22 where p value is <.001.Conclusion: Present study concluded that diabetes mellitus and periodontal disease are both interrelated and important in diagnosis and prognosis and management of periodontal disease and diabetes mellitus.
Key words: Diabetes mellitus, Periodontitis, HbA1c, Glucose

14. IRON DEFICIENCY ANEMIA AND ITS ASSOCIATION WITH THYROID DYSFUNCTION 71-76
IN SCHOOL GOING ADOLESCENT GIRLS OF SCHEDULED TRIBES IN UDAIPUR
Dr. Suresh Kumar Gautam, Dr. Ashish Sharma, Dr. Komal Sharma PDF FULL TEXT

ABSTRACT

Background: Scheduled Tribe people being about 8% of the total population in India and 13 per cent of total population of Rajasthan form a distinct group compared to other populations and is the most underprivileged section of society. The people especially women and adolescent girls are at a higher risk of under-nutrition and micronutrient deficiency leading to iron deficiency anemia. A depleted iron status may largely affect the thyroid function of tribal females and this still remains unexplored. Materials and Methods: The present study conducted in adolescent school going girls of local tribal community. Their blood samples were tested for various parameters like hemoglobin, serum iron, iron binding capacity and Throtropin stimulating hormone (TSH). Results: The investigation hereby reports anemia in 79.5% of girls. Among anaemic 47.05% were mildly anaemic and 22.5% were moderately anaemic and 9.8% of the total girls were found to suffer from severe anemia. A significant reduction in iron status confirmed anemic conditions due to iron deficiency. Significantly increased TSH levels were observed in moderate and severely anemic girls. Conclusion: A reduced iron status may result in clinical or subclinical hypothyroidism in adolescent girls.
Keywords: Anemia, Scheduled tribes, adolescent girls, hypothyroidism

15. CARDIAC AUTONOMIC DYSFUNCTION IN DIABETES MELLITUS AND ASSOCIATED FACTORS 77-81
Dr. Govind Sharan Sharma, Dr. Prahlad Dhakar PDF FULL TEXT

ABSTRACT

Background: Autonomic failure is often very disabling in diabetes. Moreover, failure to recognize the symptoms in a diabetic, as due to autonomic neuropathy, may lead to a lot of unnecessary investigations and sometimes, to wasteful treatments. Material & Methods: The present prospective study including50 Diabetic patients which were selected by simple random sampling. Institutional Ethics Committee Clearance was obtained and written informed consent was obtained from all the patients. Results: Majority 9 (18%) had early cardiac autonomic dysfunction, followed by 4 (8%) had definite, 1(2%) had atypical and severe cardiac autonomic dysfunction respectively. Mean age in cases with autonomic dysfunction was 48.67(S.D. ± 8.25) and 39.17 (S.D. ± 9.34) with no autonomic dysfunction (p<0.001).Mean duration of diabetes in cases with autonomic dysfunction was 7.93 (S.D. ± 2.22) and 5.94 (S.D. ± 2.71) with no autonomic dysfunction (p<0.05).Mean BMI in cases with autonomic dysfunction was 27.49 (S.D. ± 2.79) and 24.05 (S.D. ± 3.30) with no autonomic dysfunction (p<0.001).Among 26 cases with >7 HbA1c, 11 had autonomic dysfunction and 15 cases did not have autonomic dysfunction. Among 24 cases with ≤7 HbA1c, 4 had autonomic dysfunction and 20 did not have autonomic dysfunction (p<0.05). Conclusion: Incidence of diabetic autonomic dysfunction was more in age group 41 to 50 yrs. Increased age and body mass index were risk factors for occurrence of diabetic autonomic dysfunction. Increased duration of diabetes and raised HbA1c value were associated with occurrence of diabetic autonomic dysfunction.
Key words: Diabetes, autonomic dysfunction, HbA1c.

16. SEX DETERMINATION OF HUMAN HIP BONES BY DISCRIMINANT FUNCTION 82-87
ANALYSIS BY USING ISCHIOPUBIC INDEX
Dr. Mohammad Sharique, Dr. Tejendra Singh, Dr. Jaskaran Singh PDF FULL TEXT

ABSTRACT

Background: The four characteristic features for biological identification are sex, age, ethnic background, and stature. Accurate methods of sex estimation from the human skeleton by using various criteria are important while dealing with the undocumented human skeletal material. There are many methods of sex estimation that can be implied to the human skeleton. Methods are varying from visual assessments to metric analyses for sexually dimorphic traits. Material &Methods: The study had been conducted in the Department of Anatomy, S.P. Medical College, Bikaner and Other Medical Colleges of Rajasthan on 200dry adult human hip bones having no deformity or fracture. Ischio-pubic index = Pubic length X 100 / Ischial length was used for sex determination. Results: Mean differences of the ischiopubic index was highly significant between definite male and definite female with P-value is <0.001. The ischial length was also shown significant difference P - the value of 0.0521. Between definite male and probably female, mean differences of the ischiopubic index was highly significant P-value <0.001. Pubic length (P=0.0412) was also showed a significant difference between definite male and probably male. Between definite male and don't know, ischiopubic index (P=0.009) showed a significant difference. Between probable male and definite female, ischiopubic index (P=< 0.00032) was highly significant. Between a definite female and probably female, ischiopubic index (P=0.0019) showed the significant mean difference. Conclusion: We concluded from the present study that the single best parameter found by discriminant function analysis in the present study is ischiopubic index. But still, there was considerable overlapping in the range.
Keywords: pubic length, ischial length, ischiopubic index.

17. STUDENT PERSPECTIVES OF PROBLEM BASED LEARNING (PBL): A BOON TO KNOWLEDGE 88-92
Aruna Chanu Oinam, Dr. B.K. Manjunatha Goud PDF FULL TEXT

ABSTRACT

Background: In medical education, there is a need for implementing new methods of teaching-learning for the present generation of medical students. This will help them to achieve desired learning outcomes and competencies. Problem-based learning empowers learners to conduct research, integrate knowledge and apply appropriate skills for understanding problems and sometimes even to develop a solution. Various studies have put forward the different characteristics which make a successful PBL. A study has shown that successful implementation depends on developing a sound PBL philosophy, strategies, and tactics of problem-based learning. Problem-based learning provides a constructive instructional methodology that has shown much promise in its application in many disciplines especially where students encounter cases. It also stimulates the students to learn and apply the knowledge in contextual situations. Personal knowledge is defined as the unique frame of reference and knowledge of self, is central to the individual’s sense of self, and is a result of the individual’s personal experiences. Much of the knowledge a practitioner uses in problem-solving and making clinical judgments is tacit and individual. In conclusion, it can be said with a certain amount of strength, arising from personal experience and review of literature that PBL learning is an interactive teaching-learning methodology, which promotes self-directed learning, responsibility, critical thinking, development of contextual knowledge base and motivation among students.
Keywords: Problem based learning, Education, students.

18. COMPARATIVE STUDY OF COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING
TECHNIQUE IN DETECTION, CHARACTERIZATION AND ANALYSIS OF NECK MASSES 93-98
Dr. Gurneet Kaur, Dr. S.C. Baser PDF FULL TEXT

ABSTRACT

Background: Study was plan to correlate the concordance between CT and MRI imaging technique in evaluation of neck masses. Material &Methods: 68 patients under went medical and radiological examinations, those are presenting with neck masses and referred to the department of radio-diagnosis. All the patients are analyzed with 64 slice CT Scan machine ( Siemen ,Somaton sensation ). and 1.5 tesla MRI machine (Seimens Avanto). Results were analysed to find out any discordance between results of these imaging techniques. Results: Comparative evaluation of sensitivity, specificity and diagnostic accuracy of CT and MRI in different benign and malignant etiologies suggested that diagnostic accuracy and sensitivity of MRI shown to be superior to CT but in terms of specificity CT Scan shows better results, while Diagnostic accuracy of MRI varies from 95 to 100% whereas for CT diagnostic accuracy varies from 75% to 98%. Conclusion: Though in recent years MR imaging is considered to be imaging modality of choice for neck masses computed tomography is extremely useful in defining bony involvement and soft tissue extent of the lesion. It is fast, widely available and suitable for even patients in whom MRI may be contraindicated.
Keywords: Neck mass, CT scan, MRI

19. IMPORTANCE OF STUDENT-LED OBJECTIVE TUTORIAL (SLOT) IN UNDERGRADUATE
MEDICAL EDUCATION 99-106
Dr. Shilpi Sahu, Dr. Manisha Tambekar, Dr. Priyanka Jadhav, Dr. Ajay S Wani PDF FULL TEXT

ABSTRACT

Background: To introduce and assess an innovative tutoring program named ‘Student-Led Objective Tutorial’ (SLOT) among Second year M.B.B.S undergraduate medical students. Materials and Methods: Faculty of department of pathology of Mahatma Gandhi Medical College, Navi Mumbai in October 2015 introduced and assessed this program. A batch of 124 second year medical undergraduate students was divided into 2 broad groups A and B. Both groups were asked to prepare a topic already taught. Group A was exposed to MCQ tests. Group B was exposed to SLOT. Group B was divided into 6 groups and each group was asked to prepare an objective question and also its rationale. They were asked to present their questions either using power point or black board. Instructions were given to divide responsibilities among each group member. Faculty was interacting with all groups while they were framing their questions. The proceedings were facilitated by two associate professors, one assistant professor and one postgraduate resident. Student feedback forms were evaluated at the end of the session. Results: About 89.5% (111) of the students favored SLOT. There was no significant difference between batches in their opinions on whether to pursue SLOT in future. 89% of the students agreed that it encouraged their participation in the study. Conclusions: SLOT is more effective in deep understanding of a subject than simple lectures. It also improved communication skills among students.
Keywords: medical students, self learning, small group learning, staff shortage, tutorial.

20. CURETTAGE VERSUS ENDOSCOPIC-ASSISTED ADENOIDECTOMY? 107-111
Vaishali kataria, Tarun Ojha, Abhay Sharma, Arpit Srivastava, Kanak Yadav PDF FULL TEXT

ABSTRACT

Background: Adenoidectomy is among one of the commonest operation performed all over the world. Most commonly used procedure is conventional curette adenoidectomy. Numerous methods had been developed such as monopolar and bipolar diathermy, laser, microdebrider, radiofrequency, coblation and endoscopic-assisted technique. Material & Methods: Thirty-two patients between the age of 4-18 years and requiring adenoidectomy for variable symptoms were enrolled in the study. All study participants underwent a preoperative assessment which includes clinical examination for nasal patency, ear examination, fiber-optic nasal endoscopy and radiography of post-nasal space. All the patients were randomized into two groups, each of sixteen. Group A undergone curettage technique and Group B undergone endoscopic assisted adenoidectomy. Results: The operative time in Conventional and Endoscopic adenoidectomy was 22.25 minutes and 40.75 minutes respectively. The post-operative remnants notfound in Group B whereas 4 patients (25%) of Group A had residual adenoid tissues. In Group A 3 patients (18.75%) had trauma whereas in Group B trauma shown in 4 patients (25%) , out of then 3 patients had minor septal mucosal injuries while 1 patient had a major injury and required anterior nasal packing. Velopharyngeal dysfunction reported in 2 patients (12.5%) of Group A and 3 patients (18.75%) of Group B. Conclusion: Endoscopic assisted adenoidectomy was safe and effective procedure for adenoidectomy. There was complete of resection and faster recovery time. On the other hand, it takes more time and had more incidence of trauma.
Keywords: Adenoidectomy, conventional curette adenoidectomy, Endoscopic assisted adenoidectomy.

21. RELATIONSHIP BETWEEN ABDOMINAL OBESITY AND GERD- A CASE DESCRIPTIVE STUDY 112-118

Dr. Mohan K. Rao, Dr. Prashanth Rai B. PDF FULL TEXT

ABSTRACT

Background: Obesity is a global health emergency reaching epidemic proportions all over the world more so in rapidly developing economy like India, posing a serious health risk to the individuals. Obesity is the primary risk factor for diseases like diabetes melitus, Ischaemic heart disease, Gastroesophageal Reflux Disease (GERD), osteoarthritis , cancer etc., GERD is a common medical condition in which the gastric contents move up into the oeasophagus and has multi factorial etio-pathogenesis. Methods. A total of 125 patients referred to endocrine OPD with symptoms of GERD were included in this study. The mean age was 47.7 years. The prevalence of obesity was more based on waist circumference (66.6%) and waist-hip ratio (85.3%) than BMI. Results. There were 50(66.6%) females vs. 18(36%) males among cases with BMI>23. The number of overweight and obese females had higher mean BMI compared to males. The proportion of females with higher waist hip ratios was higher than those within reference range (11): P value 0.006. There were more females and males with NERD than ERD, p-value: 0.03 and p-value: 0.07 respectively. Conclusions.This study has shown us that there is definite relation between abdominal obesity and GERD adding to the growing body of literature. The prevalence of obesity among GERD patients was more based on abdominal girth and waist-hip ratio than BMI. The link between obesity especially abdominal obesity and GERD is stronger in women than men.
Keywords: Abdominal Obesity, Oesophagitis, GERD, Overweight, NERD, ERD.

22. EVALUATION OF ELECTROLYTE IMBALANCE IN MYOCARDIAL INFARCTION PATIENTS AT
TERTIARY CARE CENTER 119-123
Dr. Sunil Jain, Dr. Remesh Sharma PDF FULL TEXT

ABSTRACT

Background: Cardiovascular disease is among the leading causes of mortality and morbidity across the globe. According to the World Health Organization (WHO), cardiovascular disease as a non-communicable disease is a modern epidemic. Acute myocardial infarction (AMI) is one of the manifestations of cardiovascular disease leading to mortality and morbidity. Material & Methods: The present case-control study was conducted at of our tertiary care hospital, with a study duration of six months from January 2018 to June 2018. We enrolled 50 patients with AMI and 50 healthy controls in the present study. Clearance from Institutional Ethics Committee was taken before the start of the study. Results: There were 38 male and 12 female patients in the present study. Mean age of male patients was found to be 58.12 ± 14.28 and female patients was 51.27 ± 13.26. We found a statistically significant difference among serum concentration of sodium between control (94.315±4.372 mmol/L) and case group (83.598±5.424 mmol/L). There was a non-significant difference observed related to serum potassium and serum chloride concentration. We found statistically significant difference among serum concentration of serum calcium (p-value = .004) and magnesium (p-value = .001). Conclusion: Assessment of serum electrolytes is very significant and important for the diagnosis and prognosis of acute MI. The present study shows that lower values of serum sodium were reported in patients with acute MI as compared to healthy controls.
Keywords: Acute MI, Hypokalemia, Hyponatremia, Serum electrolytes

23. ROLE OF ULTRASONOGRAPHY IN ASSESSING GALL BLADDER VOLUME IN TYPE 2 DIABETES MELLITUS PATIENTS 124-129
Dr. Roopa Goyal PDF FULL TEXT

ABSTRACT

Background: Diabetes mellitus, particularly Type 2 Diabetes Mellitus (T2DM), significantly contributes to morbidity and mortality. This study aims to unravel the prevalence of gall bladder diseases in type 2 diabetic patients, explore correlations between diabetes duration and gall bladder disease, and compare gall bladder dysfunction in patients with and without autonomic neuropathy, alongside normal individuals. Methods. A cross-sectional prospective study was conducted at the Department of Radiology, our tertiary care hospital, spanning duration of one year, following approvals from the protocol review committee and institutional ethics committee. A total of 120 patients were enrolled in the study, comprising 60 individuals diagnosed with type 2 diabetes for five years or more, exhibiting diabetic complications, designated as cases, and 60 age- and sex-matched healthy controls. The average age of T2DM patients was 46.755.32 years, while that of healthy controls was 50.256.18 years (p=0.37). Gallbladder volume and ejection fraction were measured using ultrasound, both in fasting and postprandial states. Results. The mean BMI was 25.88 kg/m(2, significantly higher than that of the control group's mean of 23.61 kg(2 (p0.001) for all). However, the Ejection Fraction was notably lower in T1DM patients (50.44 cm(3) compared to controls (77.23 cm(3) with a statistically significant difference). Conclusions. Our study underscores the significance of ultrasonography in assessing gall bladder volume in patients exhibiting diabetes. Screening for gall bladder function using ultrasound may aid in early detection and management.
Keywords: Diabetes Mellitus, Type 2 Gallbladder Diseases, Prospective Studies, Ultrasonography, Gallbladder Volume.

International Journal of Medical Sciences and Education (IJMSE)Vol. 5; Issue: 1 (Jan-March 2018), Date of Publication: 01.04.2018

International Journal of Medical Sciences and Education (IJMSE)
Vol. 5; Issue: 1 (Jan-March 2018), Date of Publication: 01.04.2018