Search

Background: Competency-based medical education (CBME) curriculum has been implemented in India since 2019 with a goal to create an “Indian Medical Graduate” (IMG) possessing requisite knowledge, skills, attitudes, values, and responsiveness. Objectives: To explore teachers’ perceptions across India at medical colleges on the newly implemented competency-based medical education curriculum. Methods: This was a qualitative cross?sectional study conducted among teachers working at medical colleges across India, between February and April 2022 (n = 192). The data collection was done using Google forms online survey platform on teachers’ perception regarding CBME, its specific components, and perceived bottlenecks. We analyzed this qualitative data using manual, theoretical thematic content analysis following the steps endorsed in Braun and Clarke’s six-phase framework. Results: The majority of the teachers (64.1%) have positively responded to the CBME curriculum’s implementation. However, it came with a caution that the curriculum should continuously evolve and adapt to regional demands. The foundation course, early clinical exposure, and the family adoption program were the specific components of CBME curriculum over which the teachers raised concerns. The need for additional teachers in each department (department-specific teacher or faculty per hundred students ratio to be worked out) and the need for enabling faculty preparedness through adequate training was highlighted. Concerns were also raised regarding implementing CBME with teachers without a medical background (especially in preclinical departments). Conclusion: It is the need of the hour for the curriculum to incorporate a systematic feedback mechanism built into the system, though which such critical appraisals can be meaning collated and acted upon, to ultimately evolve, thereby creating an “Indian Medical Graduate” for the needs of todays’ society.

Objectives: The objectives of the study were to study the sociodemographic profile, clinical features, and clinical outcome of patients admitted with rat killer poison in a tertiary care hospital in South India. Methods: A cross-sectional study was conducted among those who have been admitted with rodenticide poisoning in a tertiary care center in South India. Prior Institutional Ethical committee Permission and written informed consent were obtained. Data on sociodemographic profile were elicited. The clinical course of all those who were enrolled in the study was closely followed and monitored. All the necessary blood parameters were done on every alternate day after the admission blood investigations. The data were entered into Microsoft excel and were analyzed using PSPP software. The difference in mean blood parameters between survivors and non survivors was compared. Results: The consumption of rodenticide poisoning was higher among females (59%). Majority (58%) were married. Vomiting was present in nearly two-third of the study population and abdominal pain in 21%. Dose ingested and time of reporting to hospital were high among non-survivors. Mean bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, and International normalized ratio were higher among non-survivors compared to survivors at all the days measured. Conclusions: Monitoring of liver parameters plays a key role in assessing the prognosis of the patient and also in treating them.

Context: The objective of the study was to estimate the prevalence of anemia among adolescents 10 to 19 years of age disaggregated by age group and gender. We also assessed the determinants of anemia among adolescents. Methods: An analytical cross-sectional study was carried out between July and November 2019 in a senior secondary public school, located in Coimbatore district, Tamil Nadu, India using a predesigned, semi-structured, pretested proforma that included haemoglobin estimation using oxyhemoglobin method. Results: The overall prevalence of anemia was 88.6% (95% CI 87.2 to 89.8); it was ten percent points higher in females (93.8%, 95% CI 92.1 to 95.1) compared to males (83.9%, 95% CI 81.7 to 85.8). Multivariate regression analysis showed that early adolescents (AOR 3.05, 95% CI 2.19 to 4.24), females (AOR 6.94, 95% CI 4.90 to 9.83), those with A or B or AB blood groups (AOR 2.58, 95% CI 1.92 to 3.49), physical inactivity (AOR 2.18, 95% CI 1.43 to 3.33) and attainment of menarche (AOR 2.69, 95% CI 1.73 to 4.21) were independent predictors of anemia in adolescents. Conclusion: It is the need of the hour to identify vulnerable groups; factors that predict occurrence, prioritize them to design and implement an effective public health action. Also, the effectiveness of existing strategies in the form of periodic deworming, Iron and Folic acid tablets (IFA) should be reassessed.

Objective: This study was undertaken to evaluate the effect of vestibular stimulation on motor coordination in Parkinson’s disease (PD) induced mice. Methods: 18 healthy adult male Swiss albino mice were used in this study. Vestibule was stimulated by caloric vestibular stimulation (CVS). Pesticide Rotenone was used to induce Parkinson’s disease (PD). Motor coordination was assessed by the fall-off time and the activity score using the rotarod and actophotometer, respectively. Results: In the rotarod test, there was a significant increase in the fall-off time (p

Introduction: The menisci are made up of fibrocartilage. The menisci are prone for injuries and treated by meniscal repair, meniscectomy and the meniscal allograft transplantation. The knowledge about the morphometry is necessary for orthopaedician, embryologist and morphologist. Aim: To analyse the morphometric parameters of medial and lateral menisci in the knee joint of foetuses. Materials and Methods: A cross-sectional observational study was conducted in the Department of Anatomy, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, during the year May 2015 to May 2017 in seven males and eight female foetuses with gestational age ranging from 20-37 weeks. After dissection, the morphometric parameters like peripheral and inner length, width and thickness of anterior 1/3rd, middle 1/3rd and posterior 1/3rd of the menisci was measured using digital vernier callipers. ANOVA and paired t-test was used to compare the parameters between gender and sides. Results: The morphometry was studied in 14 male and 16 female knee joints (30 medial and 30 lateral menisci). In the medial menisci width of anterior 1/3rd was significantly narrower than the middle and posterior 1/3rd. In lateral menisci, width of middle 1/3rd was greater than anterior and posterior 1/3rd which was statistically insignificant. There were no statistically significant morphometric differences between gender and sides. Conclusion: The part of the menisci which were narrower was less prone for injuries. The knowledge of the morphometric parameters in particular the width and thickness of the menisci determines the commonest area of injury. This study provides morphometric data of menisci in foetuses as it is scarce.

Background: The new competency based medical curriculum was introduced in India from 2019. The curriculum implementation support program (CISP) developed by medical council of India, provides the much-needed intellectual support to colleges for smooth transition from existing to the new curriculum. This study was done to assess the effectiveness of CISP program by comparing the pretest and posttest questionnaire.Methods: This retrospective cross-sectional study was conducted among 30 medical teachers in a medical college after getting Institutional Ethical committee clearance. During the CISP training program, a structured and validated questionnaire were administered, and it was evaluated and compared before and after the workshop.Results: There was a significant improvement in the knowledge of electives, meaning of curriculum, knowledge on curriculum delivery process, knowledge concepts of Miller’s pyramid, hardens integration ladder, GMER and the concepts of SLO. Though there is a significant improvement, the knowledge gained on foundation course, Miller’s pyramid and GMER are still poor (mean score

Aim and background Lumbar disc degeneration (LDD) is thought to be multifactorial in origin. Very recently the focus has shifted to the involvement of a family of candidate genes in the pathogenesis of LDD. There is particular emphasis on the vitamin D receptor gene (VDR gene). The VDR polymorphisms FOK1, TAQ1, and APO1 have been variably associated with LDD. Objective To evaluate the association between the FOK1/Taq1 genes and LDD. Materials and methods One hundred unrelated healthy (asymptomatic) individuals who presented for routine health checkup and 93 consecutive patients (43 males and 50 females) with no history of low back pain were enrolled in the study after informed consent was obtained. The MRI images of cases and controls were graded and peripheral blood samples were collected from all participants and sent for genetic analysis. Results Individuals with the dominant genotype for Taq1 had a significantly higher association with LDD than those without it. There was no association between LDD and the Fok1 genotype. Conclusion Genetic predisposition is an important risk factor for LDD.

Background: Formative evaluation has been effective in promoting active learning and a better futureperformance in students after immediate personalized feedback.Aim and Objectives: To analyze the effect of “Direct observation of procedural skills” (DOPS) assessmentand immediate feedback for first year MBBS students in estimation of RBC Count.Methodology: The study was done on first year MBBS students (n=120) during the Physiology practicalclass. Checklist for estimation of RBC count (15 steps) was prepared by six faculty members. The formativepractical test was divided into two practical sessions. During the first session, each faculty observed 4students performing RBC estimation one by one (DOPS) and the details were recorded in the checklist.Similarly in five practical classes 120 participants were evaluated and immediate feedback was given tothem for two minutes. In the second session the same procedure was followed and results were compared.Students perception about the assessment process (DOPS) was documented by feedback questionnaire asper Likert scale.Results: The mean practical marks of the participants before feedback was 8.32 ± 2.25 and after feedbackwas 10.18 ± 1.81 (P

Background: Medicine is one of the few academic disciplines that cannot be taught in the distance education mode. Hands-on practice for clinical skills and competency is critical in medical education. Although this pandemic has offered new learning modes such as teleconsultation, videoconferencing, virtual simulations, and digital podcasts, how much actual knowledge transfer and skill gain will be achieved, is unanswered. Aims and Objectives: The present study has been planned to understand the impact of COVID on medical education and to identify the factors which promoted or hindered learning during COVID-19 pandemic. Materials and Methods: This cross-sectional study was conducted among 261 willing MBBS students from various colleges of Tamil Nadu after obtaining Institutional Ethical committee clearance using a pre-validated structured online questionnaire through Google form link in online social platforms through “Voluntary opt in” method of sampling. Results: About 22.6% of the study participants were affected by COVID-19. About 46% of the participants family members suffered from COVID and all of them accepted that it significantly affected their academics. About 71.6% experienced anxiety/depression. About 93.5% were addicted to social media during class hours. About 88.1% welcomed “flipped/blended learning”. More than 90.8% reported that they missed skill-based learning/Primary health care training. About 80.8% positively felt that they got more duration for preparing exams. About 89.3% found that practical exams were challenging. Conclusion: Not only have we witnessed the importance of having a robust health-care system, but the pandemic has created a critical need to transform various aspects of medical education especially to a model of blended learning of online and offline methods to enable a better academic environment so as to reflect the changing medical landscape.

Background: Gastrointestinal (GI) autonomic neuropathy and reflux esophagitis are common in chronic diabetics. To gauge the adequacy of peristalsis, high-resolution esophageal manometry is considered as a reliable test. Aim and Objective: To compare the GI symptoms and high-resolution manometry parameters between type II diabetes patients and normal volunteers. Materials and Methods: This comparative study was conducted on 35 known type II diabetes mellitus patients (hemoglobin A1c [HbA1c] levels ≥6.5%) and 35 normal volunteers between the age group of 35 and 70 years. Sociodemographic details, drug history, disease duration, and GI symptoms were elicited among the study participants. HbA1c and High-resolution manometry were measured for all the participants. Results: The frequency of epigastric pain (31.48%), heartburn (34.28%), pharyngeal irritation (31.43%), and loose stools (37.14%) were significantly higher in the diabetics. Significant difference (P < 0.05) was observed in mean basal expiratory pressure (MBEP) and mean basal inspiratory pressure (MBIP) values between diabetics and controls. There was a positive significant correlation between esophagogastric junction contractile integral and MBIP (r = 0.557), MBEP (r = 0.583), Median Integrated Relaxation pressure (r = 0.410). Conclusion: Hyperglycaemia seems to be an independent risk factor for gastroesophageal reflux disease (GERD). Obesity significantly increments the occurrence of GERD in diabetics. Strict adherence to preventive measures such as weight reduction, diet management, glycaemic control will have a great impact on the occurrence of GERD in diabetics.

Background: Women in India are restricted in their daily activities and mobility due to taboos, cultural barriers associated with menstruation and menstrual practices. Poor menstrual hygiene can make them susceptible to various reproductive tract infections. In this study we assessed the awareness, knowledge of menstruation and practice of menstrual hygiene among adolescents.Methods: A college based cross-sectional study was conducted in the field practice area of an urban health training centre (UHTC) of a tertiary care hospital in the district of Coimbatore. Universal sampling method was used for selection of participants. A structured proforma was used for data collection. Microsoft excel 2007 was used for data entry and data analysis was done using SPSS version 27.Results: It was found that 80.4% had formal education on menstrual hygiene. 94.5% of them had the habit of changing pads/cloths before they go to bed. 94.1% had the habit of washing with water every time and 76.49% of those who had the habit of washing used soap/antiseptic while washing.Conclusions: Knowledge about menstruation and menstrual hygiene should be provided in schools and colleges. Ensuring availability of sanitary products, water, privacy and appropriate waste disposal in all public services and institutions can address the challenges.

Background: Depression among elderly is the commonest psychiatric disorder however it is commonly misdiagnosed and under treated. Most of the time it is considered as part of aging process rather than a treatable condition. Diagnosing depression in the elderly is often difficult as a result of presence of cognitive impairment as well as reluctance and denial by the elderly and their family members. Objective of the study was to estimate the prevalence of depression among elderly rural population in South India. Methods: A community based cross sectional study was conducted over a period of 2 months among 575 elderly people aged 60 years and above in the rural field practice area of a tertiary care hospital in south India using a pre validated Geriatric Depression Scale. Data entered and analysed using MS Excel.Results: 77.56% of the study participants were found to be depressed. Among them 74.66% were mild depressive and 25.34% had severe depression. Depression was common in elderly males as compared to females. The prevalence of depression was higher in those who live single and those living with their children without their spouse and those with co morbidities.Conclusions: Prevalence of depression among elderly is high in rural areas. It also increases as the age increases. Early identification and timely intervention would promote healthy old age.

Background: Owing to change in behavior and lifestyle patterns, diabetes mellitus and hypertension are in increasing trend worldwide. They are associated with various complications resulting in high morbidity. Early detection of these would necessitate the prevention of complications associated with it and improves the quality of life of the people. The objective of the study was to assess the prevalence and determinants of diabetes mellitus and hypertension among urban population in the field practice area of a tertiary care hospital in Coimbatore.Methods: 299 individuals of both sexes belonging to six wards in the field practice area of a tertiary care hospital in Coimbatore were randomly selected and screened for diabetes mellitus and hypertension. Diagnosis was based on American Diabetic Association and JNC 7 guidelines for diabetes mellitus and hypertension respectively. Data on various factors associated was collected using pretested validated semi structured questionnaire.Results: Overall prevalence of diabetes mellitus and hypertension was found to be 32.44% and 38.8% respectively with newly diagnosed diabetes mellitus and hypertension of 4.02% and 7.37%. Overall adherence was found to be 80%. Factors such as elderly age, sedentary life style, non-vegetarian diet, obesity are found to be associated with both diabetes mellitus and hypertension.Conclusions: Almost one in every third person found to be having either diabetes mellitus/hypertension or both with 20% non-adherence to treatment. This high prevalence necessitates the need for adoption of various strategies to combat the risk factors and to promote healthy life style.

Background: Effective communication plays a crucial role in establishing strong Doctor patient relationship which plays a dominant role in the treatment. Since Attitude forms the basis for the behaviour, the attitude of the students towards learning communication skills have major impact on developing effective communication skills. The objective of this study is to assess the level of attitude of medical students towards learning communication skills.Methods: A cross sectional study was conducted over 2 months among first to 4th year medical students in Karpaga Vinayaga Institute of Medical College and Research Centre, Kancheepuram using communication skills attitude scale. Data regarding the attitude and various socio demographic profile were collected through self-administered questionnaire. Hierarchical cluster analysis and K mean cluster analysis was done and Chi square test applied to find out association between the attitude and demographic variables.Results: With K mean cluster analysis, 183 students (47.9%) had high and 52.1% had moderate attitude towards learning communication skills. There is no significant association between socio demographic profiles and attitude towards learning communication skills except for the year of study and the gender.Conclusions: Overall all the students showed positive attitude towards learning communication skills, however there was decrease in level of attitude with higher the year of study.

Background: Alcohol use is associated with serious public health problems thereby raising the global morbidity and mortality. The main aim of this study is to estimate the prevalence of alcoholism and its co morbidity pattern among urban adult population in Salem district, Tamil Nadu.Methods: A community based cross-sectional study was carried out among urban adult population in Salem district involving 493 participants. Convenient sampling method was used. Informed consent was obtained from each participant and information was collected by using a predesigned structured questionnaire. Microsoft Excel 2007 was used for data entry and SPSS version 24 was used for data analysis.Results: It was found from the study that the prevalence of alcoholism was high. Alcohol use in any form was found in 38% of the study participants. 8% of the participants confessed that alcohol is an eye opener to them. 6% of the participants lost their job and 15% of the participants were hospitalised due to alcohol.Conclusions: The study showed higher prevalence of alcohol use among urban adult population in Salem district. Awareness about the ill effects of alcoholism among the population and necessary rehabilitation will help to reduce alcoholism consumption and its related disorders.

Background: Developing countries like India are experiencing increased burden of non-communicable diseases causing significant morbidity and mortality, both in urban and rural population. In this study we assessed the Risk factors of NCDs and its burden.Methods: There are four slums in the field practice area of UHTC, Annapoorana Medical College, Salem. Out of which one slum was selected by lot sampling and the participants by simple random sampling method. This survey included a total of 512 participants (272 males, 240 females) of age >20 years. The participants were interviewed with a pre-tested questionnaire. The study instrument was based on WHO STEP wise approach for surveillance of NCDs. STEP 1 and STEP 2 were used in our study. The performa included anthropometric measurements, blood pressure and questions related to tobacco use, alcohol consumption, dietary pattern, physical exercise. Microsoft Excel 2007 was used for data entry, SPSS version 24 for data analysis.Results: It was found that the prevalence of risk factors for NCDs was high. Tobacco use in any form was seen in 21.3% of the study population, alcohol consumption in 28.1%, overweight and obesity in 20.7%, sedentary habits in 84.6%, irregular intake of green leafy vegetables and fruits in 85% and high salt intake in 38.5% was observed.Conclusions: The study showed higher prevalence of risk factors for NCDs. This alarms the heavy future burden of NCDs in the urban slum that requires appropriate early actions to prevent risk factors, reducing the disease burden.

Background: Hypertension is a chronic condition of concern due to its role in the cardiovascular complications. Poor compliance is assumed to be an important explanation for inadequate blood pressure control, convincing evidence for the same is lacking. This study was undertaken to provide such evidence, so that corrective measures can be recommended to attain better BP control. The aims and objectives of the study were to study compliance pattern and side effects of anti-hypertensive drugs among the known hypertensive patients; to study role of different factors that influence the compliance rate such as age, number of medications, frequency and follow-up visits of antihypertensive medication.Methods: A total of 207 hypertensive patients were identified from the family folders maintained in the Urban Health Centre, RMMCH and included in the investigation. During first visits, socio-demographic, drug intake history was taken. Follow up was done every two months and thus totally six visits were completed.Results: Socio demographic factors like age, marital status, literacy, occupation and income have no role on the compliance status. Sex has significant association with the compliance level (86.1%), where males have 93.4% and females 82.7% compliance (p