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Introduction: Team-based Learning (TBL) and Problem-based Learning (PBL), both active teaching methodologies, are known for improving problem-solving abilities, clinical reasoning, and motivating students for self-directed studies. Although both active methods, TBL and PBL, differ in methodology and required resources, it is always a challenge to choose active methods that are more feasible and effective in the undergraduate medical curriculum. Aim: To compare two active teaching strategies, viz., the effectiveness of TBL vs. PBL in first-year Bachelor of Medicine, Bachelor of Surgery (MBBS) students in terms of learning outcomes, development of critical thinking skills, and retention of knowledge. Materials and Methods: This quasi-experimental study was conducted at Department of Biochemistry, NKP Salve Medical College and RC Nagpur, Maharashtra, India from August 2017 to October 2017. A total of 150 first-year MBBS students were included in the study. TBL and PBL were performed following the protocols of their respective methodologies, and scores for learning gain and critical thinking were compared between the TBL and PBL groups. Student perception regarding the procedures was collected using a prevalidated structured questionnaire. The retention of knowledge was assessed by comparing scores from a pretest and a test conducted two months later. Data were statistically analysed using the Wilcoxon signed-rank test and the Mann-Whitney U test. Results: In the present study, the mean age of the participating students was 20±2 years. Post-test results, obtained just after the intervention, demonstrated a significant learning gain in students using both methods, with a statistically higher gain in TBL (p-value

Background: There is a feeling of uncertainty in the COVID era and the graduate students are facing the challenge of being disconnected from the college. Mentorship has been shown to be essential for the attainment of skills as well as psychological development. The mentor-mentee relationship is a continuous process to dissolve the boundaries, and hence, e-mentoring could be one of the ways in which both the students and teachers connect. Material and Methods: A mentorship program called e-anubandh was designed and implemented. Six hundred medical undergraduate students were grouped with 47 faculty and 94 senior students. An online session was conducted in groups. At the end of the mentorship program, the feedback and perception of the mentors and mentees were taken using both open-ended as well as closed-ended validated questionnaires. Results: A total of 308 (out of 438 who participated) students, 94 senior mentors and 47 faculty mentors, completed the feedback questionnaire. The majority considered the initiative taken by the institute worth appreciating. The mentees and mentors found the program useful in building student–teacher relationships. They opined that such programs should be undertaken more frequently and for longer durations. Conclusion: The e-anubandh mentorship program helped in bridging the gap between the students and teachers created in the COVID era. Both the mentors and mentees were extremely satisfied with this program and such intervention appears to be a promising strategy in the COVID period.

Gingival recession is defined as the apical displacement of the gingival margin leading to exposure of the root surface. Occurrence of the gingival recessions in the anterior teeth is a major concern for the patients as it leads to compromised aesthetics and achieving the aesthetics and functional requirements of the patients remains a major therapeutic challenge for the treating dental surgeon. Incorporating the principles of Minimally Invasive Surgical Technique (MIST), surgical trauma is minimised, thus causing less cell damage, eventually resulting in less inflammation and less discomfort. MIST aims to achieve aesthetically superior outcomes that are made possible due to improved visual acuity. Therefore, the intent of this case report was to emphasise the impact of implementing the minimally invasive surgical procedure in the management of marginal gingival recessions using the conventional Coronally Advanced Flap (CAF) and the Tarnow’s technique, with the use of microsurgical instruments and magnifying surgical loupes.

Background: Mouth self-examination (MSE) is shown as a speedy, economical, and effortless method of oral cancer detection. As previous studies were conducted in population with high literacy, the current survey was performed to explore the usefulness of MSE for finding the oral cancerous precancerous lesions in indigenous low literate population of Dehradun district. Materials and Methods: It is a cross-sectional survey which was done on the Buksa tribal communities in Dehradun district, India. Out of seven tehsils in the district, two were randomly selected, from which two villages were selected. Individuals belonging to Buksa tribe above the age of 18 years were gathered in commonplace. A total of 539 people who gave their consent were enrolled for study. Using a questionnaire, information regarding sociodemographic details, history of risk factors, and practice of MSE was obtained by interview method, followed by recording oral findings by a single expert. Later, performance of MSE was taught to the participants and they were asked to record the same. Descriptive analysis and Chi-square test were applied wherever applicable and significance level was kept at below 0.05. Results: It was observed that out of 539 participants, 220 (40.8%) practiced MSE and 319 (59.2%) have never practiced MSE. Further analysis showed that a total of 39% males and 42.7% females had MSE habits and this difference was not statistically significant (P > 0.05). In totality, the prevalence of oral lesions identified by health worker was 213 (39.5%), whereas MSE showed only prevalence rate of 69 (12.8%). MSE had low sensitivity (24.6%), whereas high specificity (87.4%) for all the lesions and most sensitive in detecting ulcers (72.7%), and highest specificity in identifying red lesions (99.2%). Conclusion: Even though the sensitivity of MSE for detecting oral premalignant/malignant lesions was low, specificity was very high. Frequent efforts to educate and encourage public on MSE may enhance efficacy and compliance.

Background: Hypothyroidism has been associated with disorders of glucose and insulin metabolism involving defective insulin secretion in response to glucose, hyperinsulinemia, altered peripheral glucose disposal and insulin resistance. Assessment of insulin resistance and homocysteine may help identifying subjects at high risk of Cardiovascular Disease (CVD). Aim and Objectives: The present study was designed to assess the susceptibility of hypothyroid patients to CVD by determining the relationship between Homocysteine (HCY) and Insulin Resistance (IR). Material and Methods: One hundred patients of hypothyroidism in the age group of 18-45 years was included in this cross sectional study. Homocysteine and insulin was estimated by ELISA method. Homeostasis Model of Assessment (HOMA) which is an index for IR was used to measure insulin resistance. Results: In the present study hypothyroid patients had several fold increase in insulin levels demonstrating IR by increased HOMA index and also increased homocysteine levels which may play an important role in pathogenesis of complications of thyroid hormone. In our study there was significant positive correlation between TSH and serum insulin values r = 0.447 and also homocysteine r = 0.302. We also found positive correlation between IR and homocysteine in hypothyroid patients with r = 0.295. Conclusion: Therefore to conclude our study emphasised the importance of TSH that is positively correlated with IR and homocysteine independent of thyroid hormones. Homocysteine and IR both are associated with endothelial dysfunction and are common mediators in the pathogenesis of accelerated atherosclerosis and cardiovascular complications.

Purpose : This study assessed the modeled probability of tumor control and organ at risk toxicities in locally advanced cervical cancer in patients treated by external beam radiation plus brachytherapy using intracavitary combined with interstitial brachytherapy (IC/IS) vs. intracavitary brachytherapy (IC) alone. Material and methods: Twenty cervical cancer patients with a mean HR-CTV volume of 47.4 cm3 and a mean width of 54 mm were planned with both IC/IS and IC brachytherapy alone. A probit model was utilized to model 3-year (3-yr) local control rate (LC), 3-yr cancer specific survival rate (CSS), and the adverse effect (AE) of the organ at risk by using a modeled data set from multiple institutions. Modeling results were used to estimate the LC, CSS, and AE of the treatments in this study. Results: Using the IC/IS technique, an EQD2 increase of 12.3 Gy to D90 (from 76.1 Gy to 88.3 Gy) of HR-CTV is expected to increase 3-yr LC and 3-yr CSS by 12.5%, and 11.0%, respectively. Comparing IC/IS to IC alone, the expected G2+ AE were 7.7% vs. 7.9% for the bladder, and 5.9% vs. 6.8% for the rectum. Conclusions : The IC/IS technique improved dose coverage to the HR-CTV without significantly increasing dose to 2 cm3 of the organ at risk (OAR) surrounding it. With different regimens of EBRT combined with BT, IC/IS can be used to increase the probability of LC and CSS, or decrease the risk of AE.

Background: Matrix metalloproteinase-1 (MMP-1) is a member of a family of enzymes that can degrade most extracellular matrix macromolecules. Extracellularly, MMPs are controlled by tissue inhibitors of metalloproteinases (TIMPs) and by mechanisms of pro-MMP activation. Levels of MMPs and TIMPs change during healing, inflammation, and normal tissue turnover. Herein we aimed to evaluate the levels of MMP-1 and TIMP-1 in gingival crevicular fluid (GCF) from periodontally healthy patients (control group) and chronic periodontitis patients before and after phase 1 therapy. Methods: In this study we examined 30 patients who had chronic periodontitis with probing depth sites ⩾5 mm and a clinical attachment level (CAL) ⩾5 mm. We included 30 periodontally healthy patients as a control. Clinical measurements such as plaque (PI) and gingival (GI) indices, papillary bleeding index (PBI), probing depths (PD), and CAL were recorded both before treatment (BT) and after phase I periodontal treatment (AT). Assays for MMP-1 and TIMP-1 were performed with an enzyme-linked immunosorbent assay (ELISA) method. Results: All clinical parameters were significantly reduced at the post-therapy visit. MMP-1 levels were significantly higher in patients BT than the controls; however, the patients AT were not statistically different than the controls. TIMP-1 levels in patients BT were significantly lower than in the controls and significantly lower than patients AT. We observed a significant positive correlation between GCF volume and MMP-1 levels. Furthermore, TIMP-1 levels were significantly negatively correlated with both GCF volume and all clinical parameters. Conclusions: We observed that as the extent of periodontal destruction increases, MMP-1 concentration increases and TIMP-1 concentration decreases in GCF. When chronic periodontitis patients were treated by scaling and root planing (SRP), the average MMP-1 concentrations decreased and TIMP-1 concentrations increased in GCF. Keywords: MMP-1, TIMP-1, Chronic periodontitis, Gingival crevicular fluid

Context: Stress in medical education is common and process-oriented. It often exerts a negative effect on their academic performance, physical health, and psychological well being. Aims: This study aims at identification of such susceptible students in the early stage i.e. first year of medical education, and to provide them essential support in the form of an intervention program to lessen the negative consequences of stress. Materials and Methods: A cross-sectional survey was carried out among the First MBBS students of NKP Salve Institute of Medical Sciences and Research Center, Nagpur, India. A 41-item questionnaire was designed to assess the sources of stress and their severity. Likert′s 5-point scale was used to quantify the extent of severity on each item. Coping strategies adopted by students were assessed by using a 22-item stress inventory, and a questionnaire based on 19 institutional stress-reducing factors was used to identify its role. Results: The survey resulted into an overall response rate of 87% (131 out of 150 students). Median stress level based on 41 items was evaluated for each student. About 29% (40 students) had median stress level greater than 3. Female students were more stressed (17.19%) than male students (14.93%). The study revealed that students generally adopt active coping strategies rather than avoidant strategies like alcohol and drug abuse. The study indicated that emotional support system is a major stress-relieving factor for students. Conclusion: Prevalence of perceived stress is high among medical students. It seems that academic-related problems are greater perceived stressors. Review of academics, exam schedules and patterns, better interaction with the faculty and proper guidance, intervention programs and counseling could certainly help a lot to reduce stress in medical students.

Background: Chronic gingivitis and periodontitis are inflammatory diseases. An important function of host sialic acid is to regulate innate immunity. The aim of the study was to assess the concentration of Total sialic acid (TSA) in saliva and serum and also to find out their association if any, in periodontal health and disease. Materials and Methods: A total of 90 subjects were clinically examined and distributed into three groups (n=30) according to the periodontal status namely healthy, chronic gingivitis and chronic periodontitis.Clinical measurements including probing depth, clinical attachment level, gingival index, oral hygeine index were recorded .TSA concentration was determined in saliva and serum of all subjects. Results: In healthy group the mean salivary TSA level was 39.05mg/dl ±6.35(p