Search

t(TskBL) is a simulated learning approach in which the focus for students is a real task done by a medical professional. TskBL includes standardized patient encounters and is helpful to provide early clinical exposure. Our study aimed at planning, implementing, and assessing TskBL among first-year medical students and comparing it to the conventional method of tutorials in the physiology MBBS curriculum. This is a nonequivalent group quasi-experimental study approved by the institutional ethics committee. TskBL was conducted for seven topics among first-year medical students of Kasturba Medical College, Mangalore for three academic years. Participants were divided into a TskBL group and a control group. Both groups attended the theory classes in physiology, practical sessions, and clinical examinations concerning the tasks. After this, the TskBL group underwent TskBL, and the control group underwent tutorials. Pretest and posttest assessments were conducted by using a multiple choice question (MCQ) test and objective structured clinical examinations (OSCEs).The mean TskBL scores for MCQ (exception: hypertension, myasthenia gravis, and chronic obstructive pulmonary disease) and OSCE (exception: anemia and hypertension) were significantly higher than the tutorial group. Pretest and posttest scores revealed significantly higher MCQ and OSCE scores for TskBL (exception: MCQ score for hypertension and chronic obstructive pulmonary disease). The tutorial group did not show a significant improvement in test scores for all the tasks. The TskBL strategy could be used for topics that are likely to be encountered by the students during clinical attachments. Small group teaching can include TskBL in preference to tutorials to provide early clinical exposure in medical schools.

Objectives: Globally, stroke is known to be one of the major health problems, resulting in disability among an aging population. Rehabilitation is a process of re-learning of skills, lost due to brain injury. Many factors influence motor learning post neurological insult and practice is one of the key factors which influence relearning or reacquisition of lost motor skills. Practice can be varied concerning order (blocked or random), scheduling (massed or distributed), or whole and part practice. The study observed the effect of variations in practice schedules on motor and functional recovery. Materials and Methods: Thirty-two acute stroke subjects were recruited and equally divided into two groups (16 in massed and 16 in distributed). Both groups received an accelerated skill acquisition program (ASAP) for six sessions a week for 2 weeks. Pre- and post-outcome measures included stroke rehabilitation assessment of movement (STREAM) for motor recovery, modified Barthel index (MBI) for functional recovery, and brain-derived neurotrophic factor (BDNF) for neuroplasticity. Results: The median scores of participants in the massed practice group before the intervention, of STREAM total, MBI, and BDNF were 23.5, 19, and 0.65, respectively, whereas post values of STREAM total, MBI, and BDNF were 40.5, 60.5, and 0.75, respectively. The median scores of the distributed practice group of the pre-STREAM total, MBI, and BDNF were 23.5, 6.5, and 0.70, respectively, whereas the post-STREAM total, MBI, and BDNF were 41, 45.5, and 0.80, respectively. P-value was reported to be <0.05 while comparing pre- and post-values of STREAM, MBI, and BDNF within both intervention groups. The median change scores of STREAM, MBI, and BDNF reported P ≥ 0.05 when compared between the groups. Conclusion: Both the groups had significant recovery post-intervention designed based on ASAP, about impairment mitigation, pursuing skilled movement leading to significant functional gains. Appropriate timing along with optimal dosage became an active ingredient in functional recovery in acute stroke subjects. The distributed practice might have added effect of spacing, resulting in easier learning and accuracy of skills. The study reveals that distributed practice can be part of regular clinical practice to enhance functional recovery in acute stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Background: In India, a number of diabetes patients are rising, around 41 million Indians are suffering from diabetes. The depressed mood of an individual restricts the performance of that individual—socially, financially, and health-wise. Purpose: Patients with diabetes having depression have shown worst diabetes outcomes in contrast to those suffering from type II diabetes mellitus (T2DM) only, perhaps due to neglect at retaining a specific dietary regimen to control blood sugar levels, and/or not complying with regular exercise, consistent lifestyle, and treatment course. Our study aimed to analyze the presence of undiagnosed depression among adult diabetes patients and correlate complications and duration of T2DM with depression. Methods: This cross-sectional observational study was conducted on diabetes cases visiting Out Patient Department (OPD) at Tertiary Care Hospital in South India. After obtaining ethics committee clearance, known diabetes adult patients on regular treatment fulfilling selection criteria, and willing to join in the study were randomly selected. Participants were interviewed, clinically examined and data pertaining to sociodemographic characteristics, comorbid conditions, clinical parameters etc., were collected. Depression was judged using the Hamilton Depression Rating Scale (HDRS17) questionnaire. The association of depression with glycemic control, duration, and comorbidities associated with T2DM was studied. Results: Of 224 T2DM patients studied, the average age was 58 years, with a Male-to-Female ratio 2:1. In total, 49 (22%) had undiagnosed depression, and 175 (78%) were not having clinically obvious depression. In our study, depression was significantly associated with older age, occurrence of complications like retinopathy, neuropathy, nephropathy, and heart disease, and duration of diabetes (p <.005). Conclusion: Almost a fifth of diabetes individuals had undiagnosed depression. Proper diagnosis of depression among T2DM patients and intervention at right time can change the prognosis for patients, preventing further morbidities. [ABSTRACT FROM AUTHOR]

Introduction: Anthropometry is a simple reliable method for quantifying body proportions by measuring body length, weight and circumferences. Aim: Our intention in this study was to compare sensitivities and positive predictive values of waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR) and body mass index (BMI) in identifying healthy subjects, males and females separately for identifying obesity associated dyslipidemia. Materials and Methods: We analysed randomly selected 100 healthy subjects (males:58%, females:42%) between 25 and 60 years of age attending tertiary health care center in South India, after obtaining informed consent and Institutional Ethical Clearance. WC, WHR, WHtR and BMI of all the enrolled subjects were measured and estimated. Their fasting serum lipid profile was assessed. Subjects were divided based on their gender and each group was then categorized as obese and non-obese using anthropometric parameters and their individual serum lipid profile values depending on the cut off standards as per WHO and ATP III guidelines and compared. Data obtained was statistically analysed. Results: Mean values of WC, WHR, WHtR and BMI were highly significant (p<0.000) in obese in both males (97.43 ± 6.21cm, 0.96 ± 0.04, 0.61 ± 0.05, 27.72 ± 2.45kg/m2) and females (91.82 ± 5.18cm, 0.92 ± 0.06, 0.60 ± 0.04, 27.70 + 3.44kg/m2) when considered separately compared to non-obese males (82.27 ± 5.33cm, 0.83 ± 0.033, 0.51 ± 0.03, 22.80 ± 2.11kg/m2) and females (71.68 ± 7.33cm, 0.78 ± 0.03, 0.48 ± 0.03, 21.82 ± 1.98kg/ m2 respectively). WC was more sensitive for predicting the altered lipid profile (85%) in females and WHR (65%) in males. WHR showed higher ability to correctly predict the occurrence of dyslipidemia in the obese males (90% positive predictive value) and WHtR in females (92%). Conclusion: The present study inferred that WC, WHR are more sensitive while WHR and WHtR have a higher positive predictive value than BMI in identifying dyslipidemia in healthy males and females. [ABSTRACT FROM AUTHOR]

Introduction: Mastication has potential to affect postprandial blood glucose levels by affecting cephalic phase of insulin release. However, limited number of studies done in this regard has yielded conflicting results. Aim: To evaluate effects of mastication on postprandial blood glucose levels. Materials and Methods: We compared routine and thorough mastication in 2 separate groups: dysglycaemic (prediabetics and diabetics) and normoglycaemic in prospective interventional study. Blood glucose levels were measured pre-prandial and postprandial (after 2 hours) on separate days after routine and thorough mastication in both groups. Results: In normoglycaemic group, thorough mastication significantly reduced postprandial blood glucose levels at 2 hours (128.25± 7.82 mg/dl on routine mastication vs 119.74±9.08 mg/dl on thorough mastication, p<0.05). Comparatively, in dysglycaemic group, thorough mastication had little effect on postprandial blood glucose levels at 2 hours (244.07±22.37 mg/ dl vs. 243.55±22.87 mg/dl). Conclusion: In normoglycaemic group, postprandial blood glucose concentration upon thorough mastication was significantly lower, due to early-phase insulin secretion. This simple lifestyle modification of thorough mastication can be a useful preventive measure against diabetes in people with a strong family history and other risk factors for diabetes who have not yet developed diabetes or prediabetes. [ABSTRACT FROM AUTHOR]