Perception of the medical faculty for online teaching and assessment in coronavirus disease 2019

Background: Online teaching assessment was the only available choice for faculties and students during coronavirus disease 2019 (COVID-19) pandemic to continue medical education. Because of this sudden transition, there were many challenges faced by both faculties and students. Aim and Objectives: To determine perception of faculty and to evaluate the feasibility of online teaching-assessment in medical education. Materials and Methods: An observational cross-sectional study was conducted after obtaining institutional ethical approval, using pre-designed and semi-structured questionnaire administered through Google form to 101 participants who gave consent for participation. A 5-point Likert scale was used for collecting responses regarding perception and attitude. Responses were collected, tabulated and analyzed statistically in Microsoft excel by calculating percentages, mean score, and standard deviation. Chi-square test was used to analyze qualitative data. Results: Out of 101 participants, 46% wanted to restrict online teaching to the COVID era only.71% thought that they required more training, better infrastructure, and technical resources for effective online learning and assessment. 84% agreed that online teaching has a limited role in learning of practical skills which is a very important aspect of medical studies. Conclusion: Perception of faculties about online teaching-assessment is that it should be restricted to COVID era only or as a supplement with better infrastructure and training for effective learning and to enhance self-directed-learning in medical students along with routine off-line teaching-assessment.

Perception of medical students for online learning and assessment during the COVID era

Background: Online learning became a popular mode of education in the recent Corona Virus Disease-2019 (COVID-19) pandemic. For medical field in India, online mode of learning and assessment is novel. Aims and Objectives: This study aims at determining the attitude of students, identifying unacknowledged problems and their possible solutions associated with online learning, and to explore the future scope of online learning and assessment for medical education in India. Materials and Methods: The study population consisted of 199 medical students who had taken continuous six months of online learning and assessment in the 2020 COVID-19 pandemic period over varzious platforms such as Google Classroom, Zoom Meet, Cisco Webex etc. A questionnaire was made on Google form and distributed through online platforms, and students’ responses with informed consent were collected and analyzed. Responses were in form of Likert scale that ranged from “Strongly agree” to “Strongly disagree.” Results: About 41.4% of participants agreed that online learning and assessments save time and resources. About 78.3% of students agreed that technical errors make it difficult to continue online classes. About 78.3% of students agree that responsibility of learning is on students. About 77.7% of students agreed that academic integrity and honesty are vital in online assessment. Conclusion: If online classes can be improved by solving technical errors, better infrastructure, and faculty training, it may be continued as a supplement to classroom education for lectures, but not for practicals.

Study of eosinophil to monocyte ratio and its association with arterial blood pressure in hypertensives

Background: Total white blood cell (WBC) count is an effective marker of chronic inflammation. Granulocyte, specifically eosinophil play significant role in endothelial dysfunction, vasoconstriction, inflammation, and thrombosis. Along with eosinophil, previous studies reported increased activity of monocytes in hypertension (HT). Nowadays, in a medical research, we are using mathematical calculations, which is more accurate in this study. Aim and Objectives: This study was conducted to find out association of total WBC count and eosinophil to monocyte ratio (EMR) in hypertensives and normotensives. Materials and Methods: In study group, 50 hypertensives aged 40–60 years, males and females with the history of previously diagnosed HT >1 year duration, or taking antihypertensive medications with blood pressure (BP) Systolic BP (SBP) >140 mm Hg, Diastolic BP >90 mmHg were taken. In control group, 50 normotensives aged 40–60, males and females with SBP <140 mmHg, DBP <90 mmHg were taken, who were matching socioeconomically with study group. BP was measured, and venous blood samples were collected with proper aseptic precautions. Results: Study shows significantly (P < 0.05) high total WBC count, Eosinophil count and Monocyte count in hypertensives. EMR is also high but it is statistically not significant. Conclusion: High total WBC count, eosinophil count and monocyte count predicts risk of adverse cardiovascular events but change in EMR is not associated with HT.

Factors determining place of delivery of pregnant woman: A cross-sectional study conducted in Western part of Gujarat

Background: Institutional delivery with appropriate delivery care is one of the key paths toward achieving maternal mortality ratio target of sustainable developmental goals-3. Delay in receiving timely and adequate care at health facility is deciding factor in reducing maternal mortality. Importance of closeness of health facility, cost at private hospitals, spiritual factors, social factors, etc., play a crucial role in deciding place of delivery. Important indicator of Reproductive, Maternal, Newborn Child plus Adolescent Health programme for antenatal care (ANC) is early registration of pregnancy, minimum three (upgraded to four) antenatal checkups, proportion of delivery conducted by skilled birth attendant, etc. Various demographic factors and ANC factors play a crucial role in selection of place of delivery. Objectives: The objectives of this study were to examine the demographic factors and ANC in determining place of delivery. Materials and Methods: This community-based cross-sectional retrospective study was conducted in eight Primary Health Centre areas of Jamnagar district of Gujarat during September 2015–August 2016. Multistage sampling was used and convenient samples of a total of 400 mothers who delivered during the past 6 months were taken as study participants. Chi-square test and Fisher’s exact test were used for analysis. Results: Among the study participant mothers, 384 (96%) had institutional delivery while 16 (4%) mothers were delivered at home. Statistically significant difference in place of deliveries was found among caste (P < 0.05), among different socioeconomic classes (P < 0.01), and among different education level of mothers (P < 0.01). Among 16 home deliveries, 10 (62.5%) were neither registered during antenatal period nor received Mamta Card. Conclusion: Increasing education level of females, 100% ANC registration, and minimum four ANC checkups are the key steps toward 100% institutional deliveries.

Gender preference for child among reproductive age group women - A cross-sectional study in Jamnagar district

Background: Today, female feticide and gender preference are a big problem in India. Although there is so much emphasis against it, the problem has become aggravated. In this context, various studies showed that the male child preference leads to skewed sex ratio. The present paper is an attempt to determine the view of the people for giving their preference to the male child. Objectives: The objectives were to study the preference of women for gender of child, as well as reasons for preference for it, and association between socioeconomic factors and demographic factors with gender preference. Materials and Methods: It is a community-based cross–sectional study, in which 500 married women of 15–49 years of reproductive age group, 150 randomly selected women from one urban municipal ward, and 350 randomly selected women from seven villages of rural area were constituted the study population. Widow and separated women were excluded from the study. A pre-tested, semi‑structured questionnaire was administered to each individual to collect information. Microsoft Excel 2007 software and the Chi‑square test were used. Results: Almost half of the women (51.4%) have preference for male child. Women from lower age group (65.25%), currently married (66.42%), Muslim religion (72.22%), lower education (59.01%), and low socioeconomic status (66.67%) and those who are laborer (71.83%) have male child preference. Conclusions: This study concludes that more number of females have preference for male child in women of younger age group. Muslim religion and its customs, thoughts, and rearing practices make difference. Lower socio-economic status and poor education are also major contributory factor. Male child will support in old age and will take social responsibilities are the main basic reasons found to be associated with male child preference.

Recommendations for an expert team investigating a case of cluster endophthalmitis

Occurrence of postoperative cluster endophthalmitis is a nightmare for the operating surgeon, the involved hospital, and the patients. Due to its multifactorial etiology, surveillance of such an event is extremely important to identify the causative factor and to prevent recurrences in future. For surveillance, a team of ophthalmologists and microbiologists is often appointed by the local health department, and it is imperative that this team investigates thoroughly, reports appropriately safeguarding the interests of all, and also suggests remedial measures for future. Much literature is available on postoperative endophthalmitis and sterilization and disinfection protocols, but to the best of our knowledge, there is none to guide the surveillance team regarding the conduct of the entire process of investigation in the case of such unfortunate incidents. Through this article, we have made an attempt to formulate recommendations for expert teams investigating cases of postoperative cluster endophthalmitis.

Association and treatment response to capecitabine-based chemoradiotherapy with CYP2C9 polymorphism in head and neck cancer.

Aims : The aim of the present study is to investigate the association of polymorphism in cytochrome P450 2C9 (CYP2C9) with head and neck squamous cell carcinoma (HNSCC) and response in patients receiving chemoradiotherapy. Materials and Methods : One hundred ten males suffering from locally advanced head and neck squamous cell carcinoma and an equal number of healthy controls were genotyped for CYP2C9*2 and CYP2C9*3, leading to poor metabolizers (PMs) by PCR-based RFLP. Each case was assessed thoroughly for treatment response following WHO criteria. Results : The frequency of heterozygous genotypes of both CYP2C9*2 (27.3%) and CYP2C9*3 (20.1%) were found to be significantly higher in the HNSCC cases as compared to the healthy controls. Tobacco intake in the form of chewing or smoking and alcohol intake resulted in several fold increase in the risk to HNSCC in the cases carrying variant genotypes of CYP2C9*2 or CYP2C9*3. Further, majority of the cases assessed for response (134) carrying variant alleles of both CYP2C9*2 (65.3%) or CYP2C9*3 (70.58%) were found to respond poorly to the radio-chemotherapy. Conclusions : The data suggests a significant association of the CYP2C9 polymorphism with HNSCC and treatment outcome underlining the importance of pretherapeutic genotyping in determining the treatment schedule.

Contribution of genomics, proteomics, and single-nucleotide polymorphism in toxicology research and Indian scenario.

Advancement in the molecular tools used in toxicology has provided immense information about the cellular and global structure and function of toxicant-responsive genes. Now, it has become possible to assess the functional activity of genes and proteins involved in various toxicological pathways, which were not possible with the conventional methods. Many genes are known to have a greater influence on the susceptibility to environmental agents than others; therefore, identification and characterization of polymorphism in such genes for the determination of early, late, or no response of an individual for the toxicant-induced diseases has also become mandatory. Toxicogenomics, a newly born discipline of toxicology, comprises of two major facets, one, how various genes in the genome respond to environmental toxicants and stressors and second, how toxicants modify the function and expression of specific genes in the genome. Toxicogenomics play an important role in the identification and characterization of molecular biomarkers to predict cellular toxicity and to determine the efficacy and exposure in the toxicity trials at an early stage. Genome and proteome-wide expression profiles in combination with conventional toxicology are being used to classify compounds, predict the mechanism of toxicity of newer compounds and determine the susceptibility of an individual for the toxic responses. Single-nucleotide polymorphism in toxicant-responsive genes is being used to obtain basic information of the genetic variation and its role in the functional protein expression. Various national and international government and private organizations have launched several programs on gene-environment interactions. Council of Scientific and Industrial Research (CSIR), New Delhi, India, has also launched a program on 'toxicogenomics of genetic polymorphism in Indian population to industrial chemicals for development of biomarkers' to provide better ventures and facilities to researchers in order to understand the environment-genome interactions. In this review, the contribution of genomics, proteomics, and SNPs in toxicology along with its current status in India has been discussed3.