International Journal of Medical Sciences and Education (IJMSE)
Vol. 7 Issue: 3 (May-June 2020), Date of Publication: 01.07.2020

Table of Contents
     Editorial

1.    A STUDY OF MORAL VALUES IN STUDENTS IN A MEDICAL COLLEGE IN SOUTHERN INDIA            1-8
       Muhseenah, Nallapu Samson Sanjeeva Rao                                                                         PDF FULL TEXT

ABSTRACT

​Background: Moral positions are essential for decision-making processes in medical practice. Doctors are expected to make moral decisions regarding the welfare of their patients. Decisions made in healthcare affect many non medical issues which may even affect the community and society. A moral compass is an inner sense which functions as a guide for morally correct behavior. During the course of study, a professional healthcare worker must develop a suitable moral compass Objectives: To assess and compare the moral values of medical and nursing students in a medical college using the Moral Foundations Questionnaire (MFQ). Materials and methods: This descriptive study was done at the NRI Medical College, in June and July 2019 involving 131 Medical students and 86 Nursing students. After taking informed consent, the MFQ questionnaire was administered to the students. The MFQ was developed based on a model of five universal sets of moral perceptions; Individualizing foundations like Harm/care and Fairness and traditional binding foundations like In-group/loyalty, Authority/respect, and Purity. The self-administered MFQ data was entered in MS Excel and subjected to statistical tests like z test and Chi square at 5% Level of Significance. Results: The mean scores (out of a possible total of 5 for each domain) in medical students obtained for Person focused values were Harm / Care 3.5, Fairness 3.54. Group focused values were Loyalty 3.37, Authority & respect 3.30 and Sanctity and Purity 3.20. In nursing students it is 3.24, 3.31, 3.36, 3.44 and 3.09 respectively. Discussion: Gender differences were seen in harm / care, authority and purity. Medical students scored higher in harm/care, fairness while nursing students scored higher for team work, respect for authority.  Conclusion: Moral positioning is an essential part of medical practice. Medical teachers and society must help students develop the right moral compass.
Keywords: Medical education, moral development, moral compass, MFQ, morality

2.    ASSESSMENT OF THE VITAMIN D LEVELS IN PATIENTS OF ASTHMA AT TERTIARY CARE CENTRE                                                                                                                                                                                            9-12
       Dr. Manish Kumar Jain, Dr. Nalin Joshi                                                                                   PDF FULL TEXT

ABSTRACT

Background: Vitamin D inadequacy has been connected to build frequency of respiratory sicknesses like asthma with its supplementation appeared to mitigate these impacts. Results acquired from considers utilizing experimental models and human cells with respect to the restorative impact of nutrient D supplementation has clashed those gotten from some clinical preliminaries. Material & Methods: The present prospective study was conducted at department of respiratory medicine of our tertiary care hospital. We enrolled 50 study participants from outdoor and from ward by simple random sampling, who were presented with signs and symptoms of bronchial asthma for more than 6 months. Clearance from Institutional Ethics Committee was taken before start of study. Written informed consent was taken from each study participant. Results: In the present study, the 25(OH) Vitamin D levels of total study participants was recorded. On the basis of the 25(OH) Vitamin D levels all study participants were divided in three groups respectively, Deficient levels, Insufficient levels and Sufficient levels. Out of the total, 29 (58%) study participants had deficient 25(OH) Vitamin D levels and 21 (42%) study participants had insufficient 25(OH) Vitamin D levels. None of the study participants had sufficient 25(OH) Vitamin D levels. Conclusion: We concluded from the present study that there was deficiency of 25(OH) Vitamin D levels was found among study participants but this was statistically non-significant. A non-relationship of low serum 25 (OH) D levels with airway route impediment also seen.
Keywords: Asthma, Vitamin D levels, airway route impediment.

3.    COMPARISON OF COLOR VISION DISCRIMINATION IN MALE AND FEMALE EYES AMONG YOUNG
       ADULTS- A CROSS SECTION OBSERVATIONAL STUDY                                                                      13-17
       Dr. Chhaya Gupta,  Dr. Jyotsana Shukla,  Dr. Pradeep Gupta                                             PDF FULL TEXT

ABSTRACT

​Background: Color perception is an important aspect of our life. It is well established that there is a significant difference in color vision among different peoples. Male and female have a different perception of colors. Therefore this study was done to evaluate the color perception in two genders of the same intellectual and same age. Material and Methods: A cross-sectional observational type of study was carried out including 170 young adults with normal color vision. The Ishihara pseudo-isochromatic plate test for screening of CCVD, Gundogan test for detecting Dominant Eye, and FM100HUE TEST for color vision discrimination ability were performed. Results: Total of 101 males (59.42%) and 69 female (40.58%) participants were included in the study. The mean and standard deviation Age profile of the young adults is 18.6 ± 0.91 and Median is 18. Mean and Standard Deviation of Total Error Score of FM 100 Hue test between Right Eye (RE) and Left Eye (LE) among males and females for color vision discrimination ability was found significant. Mean (±SD) Total Error Score of FM100 HUE TEST for Two Eyes with Dominant Right Eye and two eyes with Dominant Left Eye in male and female was also found significant. Conclusion: From this study, it is concluded that the color vision discrimination performance ability was found superior for females than males. We hope that with more advanced studies in the context of developing imaging techniques could found more and more descriptive information.
Keywords: Dominant Eye (DE), Farnsworth Munsell 100 Hue Test (FM100 Hue Test), Ishihara Pseudo-isochromatic Plate Test (IPPT).

4.    FEEDBACK OF FOUNDATION COURSE IN STUDENTS OF FIRST MBBS COURSE IN A GOVERNMENT
       MEDICAL COLLEGE IN MAHARASHTRA                                                                                                  18-22
       Swati Shah, Kalpana Kulkarni, Varsha Sarode, Monika Singh                                              PDF FULL TEXT

ABSTRACT

​Background: As per MCI guidelines, Maharashtra University of Health Sciences (MUHS) has started foundation course for the first year MBBS students. This study was planned with the objective of assessing the feedback of the students at the end of the foundation course. Materials and methods: It was a cross sectional descriptive questionnaire based study. Medical Education Technology (MET) cell of the institute planned one month foundation course for first year MBBS students. As per the Medical Council of India (MCI) guidelines, the program was divided into various modules viz: orientation, skill module, professional development & ethics module, sports & extra-curricular activities, language & computers. The course was taught by internal as well as external subject experts. Interactive sessions and workshops were taken. Role play and help of audio-visual aids were taken. A pre-validated feedback form in the form of questionnaire to be filled at the end of each session was given to all the students at the beginning of the course. Overall suggestions were also asked. Percentage of the students giving positive response was calculated. Results: The positive feedback of students ranged from 50-100% in various aspects of these modules. Twenty five percent students suggested that the duration of the foundation course should be reduced to 2 weeks instead of 4 weeks. Conclusion: The foundation course will help the students to develop communication skills and increase their confidence levels, teaching them professional skills and etiquettes and take them one step closer to becoming an Indian Medical Graduate.
Keywords: Foundation course, MBBS, Feedback

5.    CONCEPT MAPPING, AN INNOVATIVE EDUCATIONAL TOOL IN LEARNING BIOCHEMISTRY           23-27
       Sreekanth K. Sivaraman                                                                                                            PDF FULL TEXT

ABSTRACT

Background: Several methods are adopted for teaching and learning Biochemistry like didactic lectures, which is commonly followed in Medical Colleges across India. Concept mapping, which represents the relationship between ideas, images or words, can be used in the teaching learning process of Biochemistry. This experimental study was aimed to compare the effectiveness of concept mapping with traditional lecture classes in Biochemistry. Materials and Methods: This study was conducted with the participation of 150 students of the 1st MBBS after obtaining ethical clearance and written consents. By unconditional selection they were grouped into control (C) and Test (T) of 75 each. A topic in Biochemistry was taught to both the groups by regular lecture classes. Then the concept mapping for the same topic was introduced to the test group alone, followed by a written examination with same question paper to both the groups. Papers were evaluated, scores were given and analysis was done. Then the control group was also introduced with the concept mapping and the feedback was obtained from all.  Results: Comparison of the mean values of the scores of the control and test showed statistical significance (p-value <0.01). The individual scores of test group were also found to be better than the control group. Most of them (87%) were of the opinion that concept mapping helped them to understand and retain the knowledge in the subject. Conclusion: This study showed that concept mapping in Biochemistry is an effective teaching learning method than the regular didactic lecture alone.
Keywords: Biochemistry, Concept mapping, Feedback, Teaching learning method

6.   INTESTINAL PARASITIC INFESTATION IN AN URBAN SLUM OF LUCKNOW CITY                               28-33
      Sana Jamali, Mohammad Suhail Khan, Saleem Azmi, Ausaf Ahmad                                     PDF FULL TEXT

ABSTRACT

Background: Intestinal parasitic infections are globally endemic and are a major public health problem of concern. The prevalence is high in developing countries more in Asian countries for eg. India, Bangladesh, etc probably due to poor sanitary conditions and improper hygiene practices. The present community-based study to determine the prevalence of intestinal parasitic infestation in an urban slum area of Lucknow. Materials and Methods: This cross-sectional study was conducted between January 2019 – June 2019. Residents of an Urban Slum which is covered under the urban health training center of the Integral Institute of Medical Science and Research, Lucknow. A structured predesigned and pretested questionnaire was used. The cases were studied by doing home visits. All member of the family was interviewed. Consent was taken from the study subjects before data collection. The data was entered and analyzed with the Microsoft Excel software. Results: The overall prevalence rate of intestinal parasitic infections was 13.75%.  Entamoeba histolytica was the most common parasite which caused infection in both female and male. Between the 31-40-year age group was highly infected due to intestinal parasite. Patients who were infected with intestinal parasite their patients were suffering from abdominal pain, constipation, fever, diarrhea, and nausea or vomiting. Conclusions: This study reveals that intestinal parasite infections are a public health problem in our study population. Entamoeba histolytica was the most common parasite and the 31-40-year age group was highly infected. Large scale studies should be done frequently in order to detect the prevalence and variations in the epidemiology of parasites.
Keywords: infestation, Sanitation, prevalence, parasitic​

7.   EVALUATION OF INSULIN RESISTANCE AMONG PATIENTS OF CIRRHOSIS OF LIVER                    34-37
      Dr. Amit Anand Patel                                                                                                                   PDF FULL TEXT

ABSTRACT

Background: The etiopathology of hematogenous diabetes is complex and it is not precisely reported in previous studies but porto-systemic shunting of insulin reported in systemic hyperinsulinemia which leads to subsequent down regulation of insulin receptors which result in insulin resistance. Material & Methods: The present prospective study was conducted at the Department of general medicine of our tertiary care hospital. Patients were enrolled from the outdoor and ward by simple random sampling. Clearance from Institutional Ethics Committee was taken before the start of the study. Written informed consent was taken from each study participant. All patients with liver cirrhosis were enrolled in the present study. Results. Out of the 50 patients with liver cirrhosis, insulin resistance was found among 39 (78%) patients with a mean IR value of 5.87 ± 3.52. 11 (22%) patients reported no insulin resistance with a mean IR value of 0.79 ± 0.64. This difference was statistically significant (p-value < 0.05). On the basis of the Modified child Pugh score majority of study participants 23 were in Class C (>10) which was followed by 22 patients in Class B (7-9) and 5 patients in Class A (5-6). Out of these 2 (4%) patients of class A had IR value (>1.64) with mean IR value of 5.92±3.28 (p-value < 0.05). 2 (4%) patients of class B had IR value (>1.64) with mean IR value of 5.77±4.12 (p-value < 0.05). 20 (40%) patients of class C had IR value (>1.64) with mean IR value of 5.89 ±3.92 (p-value < 0.05). Conclusion: Insulin resistance is a better predictor of impending diabetes mellites. We further conclude that HbA1c levels and fasting plasma glucose are not sufficient in diagnosing glucose metabolism disorders in cirrhosis. We conclude that insulin resistance can be used as a prognostic marker in cirrhosis of the liver.
Keywords: liver cirrhosis, insulin resistance, diabetes.

8.  MORPHOLOGICAL DIVERSITY OF ENDOMETRIAL LESION IN WOMEN COMPLAINING ABNORMAL                     UTERINE BLEEDING                                                                                                                                   38-42 
 
     Dr. Sonal Agarwal                                                                                                                        PDF FULL TEXT

ABSTRACT

Background: DUB is one of the common problems in females and has a huge impact on women’s quality of life. It may represent a normal physiological state or can be a sign of a serious underlying condition endometrial carcinoma in 8-50% of cases. The present study is thus conducted to study the morphological spectrum of the endometrium which is essential for adequate treatment. Material and Methods-: The study was conducted in the Department of Pathology, Tertiary Care Center, Udaipur. 105 patients clinically diagnosed as DUB were included in this study over a period of five months. Endometrial samples were obtained from dilatation and curettage or endometrial biopsy. Specimens were received in 10% formalin. The gross morphology of the tissue samples was studied. Result: The most common age group (28.57%) affected was between the 4th and 5th decade which is the perimenopausal age group. The patients presented with various complaints but menorrhagia was the commonest bleeding pattern seen in 45 patients (42.86%). On categorising patients according to their parity, most of the females were multiparous (52.38%) while least was Nullipara (4.76%). On performing the histopathological examination, in a maximum of the patients with DUB, Endometrial hyperplasia (40%) was found. Conclusion: The endometrial patterns varied in cases of DUB ranging from normal endometrium to Atypia which is a pre-cancerous condition, thereby highlighting the importance of endometrial curetting and biopsy as a diagnostic procedure in the evaluation. Accurate analysis of endometrial samplings is, therefore, the key to effective therapy and optimal outcome.
Keywords: Uterus, Bleeding, Endometrial hyperplasia

9.  EFFECT OF PULMONARY  TUBERCULOSIS DISEASE ON FEMALE SEX HORMONES AND                                     REPRODUCTORY HEALTH – A PROSPECTIVE CLINICAL STUDY                                                         43-47 
     Dr. Munavver Ali Ansari                                                                                                               PDF FULL TEXT

ABSTRACT

Background: Recent medical literature shows the negative effects of pulmonary tuberculosis disease on female reproductive health with disturbance in levels of female sex hormones affecting the menstrual cycle and resulting in infertility. Thus the present prospective clinical trial was conducted to evaluate the levels of female sex hormones in females suffering from pulmonary tuberculosis and its association with reproductory health. Materials and the methods-This the prospective clinical study included 100 female participants (18yrs to 55yrs) out of which 70 patients diagnosed with pulmonary TB were taken in the test group and 30 females with no history of TB were included in the control group. All patients were evaluated for complete medical, menstrual history, clinical signs and symptoms, serum levels of FSH, LH (follicular phase), progesterone and estradiol (luteal phase). Results- Sociodemographic variable did not show any statistically significant difference between the two groups(p>0.05).Menstrual irregularities were observed in 65.8% of cases in the TB group and 10% of the controls. In the pulmonary TB group, 70 %  had menstrual irregularity, 40% had secondary amenorrhea, 14.2% had hypomenorrhea,2.8% had Hypermenorrhea, 2.8% had Metrorrhagia, and  5.71% Dysmenorrhea was noted. Serum FSH and LH levels were statistically significantly higher in the TB group as compared to controls while the serum progesterone and estradiol levels were significantly low in TB cases (p<0.05). Conclusion: Pulmonary Tuberculosis negatively affects female reproductory health and can be a cause of infertility. It disturbs the hormonal balance with subsequent menstrual cycle abnormalities. Successful treatment by antitubercular drugs could reverse these changes and restore the hormonal balance and t the reproductory health.
Keywords: Pulmonary  Tuberculosis, Female sex hormone, Reproductory health, Menstrual irregularities

10.  ADMINISTRATION OF LOW DOSE KETAMINE FOR REDUCTION OF PROPOFOL INJECTION PAIN- A PROSPECTIVE STUDY                                                                                                                                   48-51
Dr. Bhupendra Pratap Singh                                                                                                            PDF FULL TEXT

ABSTRACT

Background: The intravenous administration of propofol often leads to significant pain. Previous studies have indicated that ketamine can effectively alleviate this pain. Aims: This study aimed to evaluate the effectiveness of low-dose ketamine in reducing propofol injection pain. Material & Methods: Conducted at a tertiary care hospital's Department of Anesthesiology from February 2019 to November 2019, the randomized controlled clinical trial enrolled 70 patients aged 18-65 years undergoing surgical procedures under general anesthesia (GA) with ASA physical status I or II. Participants were randomly assigned to two groups: Group K received ketamine 100μg/kg pre-treatment, while Group S received 0.9% normal saline. Ketamine or saline was injected over 10 seconds with a forearm tourniquet, followed by propofol injection. Pain was assessed using a Verbal Rating Scale (VRS) graded from 0 to 3, and hemodynamic parameters were recorded peri-operatively. Results: In Group K, 81.5% of subjects experienced no pain, 15.6% had mild pain, and 2.9% experienced moderate pain. In Group S, 34.6% experienced no pain, 28.5% had mild pain, 25.2% experienced moderate pain, and 11.7% reported severe pain. Additionally, no statistically significant differences in mean heart rate and mean arterial pressure were observed between the groups (p>0.05). Conclusion: Pretreatment with ketamine 100 μg/kg before propofol injection resulted in a reduction in propofol-induced injection pain. This suggests the potential of low-dose ketamine as an effective strategy for managing propofol injection pain. Keywords: ketamine, injection pain, propofol.
Keywords: ketamine, injection pain , propofol, Pain management

11. CLINICOEPIDEMIOLOGICAL TRENDS OF DERMATOPHYTOSIS IN PEDIATRIC PATIENTS: PRESENTING AT        A TERTIARY CARE  CENTER                                                                                                                  52-57
     Dr. Kamlesh Verma, Dr. Jaya Verma                                                                                          PDF FULL TEXT

ABSTRACT

Background: Dermatophytosis, a prevalent fungal infection in pediatric populations, is caused by dermatophytes such as Trichophyton, Microsporum, and Epidermophyton species. The rising incidence of these infections, particularly in tropical and subtropical regions, necessitates a deeper understanding of demographic, clinical, and diagnostic factors influencing pediatric cases. Objective: This study aimed to evaluate the demographic and clinical characteristics of dermatophytosis in children, identify common infection sites, and assess the diagnostic accuracy of KOH and culture testing. Methods: A prospective, observational study was conducted over one year in a tertiary care hospital. Pediatric patients (0-14 years) presenting with clinical signs of dermatophytosis were included. Diagnoses were based on clinical evaluation, KOH preparation, and fungal culture. Samples were collected from infection sites and analyzed for fungal presence. Demographic and clinical data were statistically analyzed. Results: Out of 318 pediatric patients, the 6-9 year age group showed the highest infection rate (28.9%). The trunk (28.6%), face and neck (22.9%), and groin (20.4%) were the most affected sites. KOH positivity was observed in 84.9% of cases, while fungal culture demonstrated a higher positivity rate at 91.2%, indicating its superior sensitivity. A dual diagnostic approach was suggested to enhance detection accuracy. Conclusions: School-age children are particularly vulnerable to dermatophytosis, emphasizing the need for targeted hygiene education and preventive measures in communal settings. Combining KOH and culture tests offers improved diagnostic precision, crucial for effective management and treatment in pediatric populations.
Keywords: Dermatophytosis, Pediatric Fungal Infections, Tinea, Diagnostic Sensitivity, KOH Test, Epidemiology.