Assessment of effectiveness of Cinemeducation as a tool to impart communication skills among the MBBS 1st Professional students

Background: Improvements in healthcare providers’ communication skills have been linked to more effective healthcare delivery, improved patient compliance, better patient and provider satisfaction, and fewer lawsuits. Cinemeducation is a relatively new method of medical education where movies or movie clips are used to stimulate discussions and reflections, which is a part of an active learning process. Hence, the present study was undertaken. Methods: We conducted an educational research, mixed method study among the MBBS 1st Professional students. A pre & post test to assess the knowledge and attitude of the students about the importance of communication skills in doctor-patient relationship. Students wrote the reflection and feedback after watching the movie clip. Quantitative analysis was done using paired t test by SPSS v. 20. Qualitative data analysis was done by two investigators independently. Results: The pre & post test for knowledge was statistically significant while communication skill attitude scale score for both positive & negative was not significant. Conclusion: The student’s knowledge improved significantly after the sessions on communication skills, while negligible change in attitude was observed. Reflective writing by the students shows that cinemeducation can be used as one of the tool for teaching communication skills to the medical students.

Prevalence of Risk Factors of Non-Communicable Diseases in a Rural Population of Eastern Uttar Pradesh

Introduction: Over past few decade morbidities and mortalities associated with NCDs (Non-Communicable Diseases) leads to a significant loss of productive life years both in developed and developing countries. Therefore, the present study was done to determine the prevalence of common risk factors for major NCDs in a rural population of Barabanki district in eastern Uttar Pradesh. Materials and Methods: The present cross-sectional study was conducted in Satrikh block of Barabanki district. Multistage sampling was used for enrolment of the study subjects. A totalof 1824 participants aged ≥25 years were enrolled in the study. WHO STEPs- wise tool was used to collect information on behavioural risk factors like tobacco use, diet, alcohol useand associated anthropometric indices were measured. Results: Prevalence of tobacco smoking, smokeless tobacco products use, alcohol consumption, less than five servings of fruits/vegetables, more than five grams of salt intake and overweight/obesity was found to be 26.2%, 27.08%, 24.1%, 91.61%, 10.9% and 34.86% respectively. Individuals with age more than 35 years, male subjects, illiterates and those who belonged to scheduled castes/tribes were significantly (p<0.05) more predisposed to both smoked tobacco as well as smokeless tobacco use and alcohol consumption.Consumption of alcohol was significantly (p<0.05) higher among employed groups who belonged to upper and upper middle class while tobacco consumption was more prevalent in lower socioeconomic group. Consumption of salt more than 5 grams per day was significantly higher among individuals in elder age group (35-65 days), among females, those who were literate, those who belonged to other backward castes and among government employees. Conclusion: The study revealed high prevalence of non-communicable disease risk factors among adults. This indicates towards need of prompt community based preventive measures and control strategies to lower the forthcoming consequences of NCDs.

Infant and young child feeding practices of mothers attending immunisation clinic at a tertiary care hospital of Lucknow

Background: Adequate infant and young child feeding (IYCF) practices are essential to ensure optimal survival, health, growth, development and overall nutritional status of children. Objective: The objective of the present study was to assess the IYCF practices among mothers with children aged 0-23 months attending immunisation clinic at a tertiary care hospital of Lucknow, capital of Uttar Pradesh. Materials and methods: A hospital based cross-sectional study was conducted at immunisation clinic, King George’s Medical University from January 2015 to September 2015. Systematic random sampling was used and a total of 240 mothers with children 0-23 months old attending immunisation clinic were interviewed with the help of pre-designed, pre-tested and semi-structured questionnaire. Results: Breastfeeding (BF) was initiated within one hour of birth in 18.3% of children. Early initiation of BF was significantly associated with educational and socioeconomic status of mother and type of delivery. Pre-lacteal feeds were given to 23.4% of the children, children born at government health facility and with birth order ≤2 received pre-lacteal feeds more often. Colostrum was given by 67.9% of the mothers. Children born at private institutions or home were more likely to receive colostrum (p< 0.05). The prevalence of exclusive breastfeeding for at least 6 months was 53.8%. It was higher in children belonging to low socioeconomic group (p< 0.05). Complementary feeding was initiated at 6 months in 32.8% of children. Children of mothers belonging to upper socioeconomic Shukla M, Tyagi S, Agarwal M. Infant and young child feeding practices of mothers attending immunisation clinic at a tertiary care hospital of Lucknow. IAIM, 2016; 3(1): 58-66. Page 59 class, nuclear family and delivered at government institution through normal delivery were more likely to be started on timely complementary feeding (p<0.05). Conclusion: The study revealed that inadequate IYCF practices are still quite prevalent in the community and therefore emphasis should be given to IYCF education sessions.

Emergence of dengue in tribal villages of Mandla district, Madhya Pradesh, India.

Background & objectives: Dengue (DEN) is a rapidly spreading arboviral disease transmitted by Aedes mosquitoes. Although it is endemic in India, dengue virus (DENV) infection has not been reported from tribal areas of Madhya Pradesh. Investigations were conducted to establish the aetiology of sudden upsurge of cases with febrile illness in June 2013 from tribal villages of Mandla district of Madhya Pradesh, India. Methods: The rapid response team of the National Institute for Research in Tribal Health, Jabalpur, conducted clinical investigations and field surveys to collect the samples from suspected cases. Samples were tested using molecular and serological tools. Collected mosquitoes were identified and tested for the presence of virus using semi nested reverse transcriptase-polymerase chain reaction (nRT-PCR). The sequences were analysed to identify serotype and genotype of the virus. Results: of the 648 samples collected from 18 villages of Mandla, 321 (49.53%) were found to be positive for dengue. The nRT-PCR and sequencing confirmed the aetiology as dengue virus type 2. Eighteen per cent of patients needed hospitalization and five deaths were attributed to dengue. The virus was also detected from Aedes aegypti mosquito, which was incriminated as a vector. Phylogenetic analysis revealed that the dengue virus 2 detected belonged to cosmopolitan genotype of the virus. Interpretation & conclusions: Dengue virus serotype 2 was detected as the aetiological agent in the outbreak in tribal villages of Mandla district of Madhya Pradesh. Conducive man-made environment favouring mosquitogenic conditions and seeding of virus could be the probable reasons for this outbreak. Urgent attention is needed to control this new threat to tribal population, which is already overburdened with other vector borne diseases.

Circulation of hepatitis A genotype IIIA virus in paediatric patients in central India.

Hepatitis A virus (HAV) infection, a major cause of childhood hepatitis is transmitted by orofaecal route. Children mostly suffer with subclinical infection but may have serious clinical implications leading to hospitalization and mortality. IgM ELISA and nRT PCR were conducted on the blood samples collected from HAV suspected paediatric cases referred to the viral diagnostic laboratory in the Regional Medical Research Centre for Tribals at Jabalpur, Central India. The nRT PCR products were sequenced and phylogenetic analysis was done. of the 195 samples tested, 41 (21%) were positive for HAV antibodies, among which 38 (92%) belonged to paediatric age group and 32 per cent of these were hospitalized. nRT PCR and sequencing confirmed the presence of HAV. Phylogenic analysis revealed circulation of genotype III A in central India. Regular serological and molecular monitoring would aid in understanding epidemiology of HAV and plan intervention strategies.

Serum cortisol and testosterone levels in idiopathic central serous chorioretinopathy.

Context: The preferential occurrence of idiopathic central serous chorioretinopathy (ICSC) in males with a typical Type A personality and behavior and a relative absence in females is a possible indicator towards the role of serum cortisol and /or the male sex hormone testosterone. Aims: To study levels of cortisol and testosterone in ICSC. Settings and Design: Case-control study in a tertiary care teaching hospital. Materials and Methods: The study was conducted on 23 cases of ICSC. Twelve patients with unilateral sudden painless loss of vision of less than one month duration served as controls. Serum cortisol and testosterone levels at 8.00 a.m. were estimated by radioimmunoassay in both groups. Statistical analysis used: Statistical analysis was done using SPSS 13.0 software. Independent Sample t-test was applied to analyze statistical significance between the two groups. Results: Mean age of patients with ICSC was 37.1 ± 9.7 years and 96% of the patients were males. Mean serum cortisol levels were significantly higher (P=0.002) in patients with ICSC i.e., 495.02 ± 169.47 nano moles/liter (nmol/L) as compared to controls i.e., 362.25 ± 51.54 nmol/L. Mean serum testosterone levels were 3.85 ± 1.81 nano grams/ml (ngm/ml) and 4.23 ± 1.89 ngm/ml in cases and controls respectively and the difference was not statistically significant (P=0.58). Conclusions: ICSC is associated with elevated 8.00 a.m. serum cortisol levels. However, mean serum testosterone levels in both patients of ICSC and controls were within normal range.

Responses of cyanobacterium Anabaena doliolum during nickel stress.

Growth and biochemical responses of heterocystous nitrogen fixing cyanobacteria Anabaena doliolum were studied upon exposure to various concentrations of nickel (0.1 to 100 mM) for duration of upto 4 days, in view of its tolerance. The growth of the cyanobacterium was increased in terms of cell density (O.D), heterocyst frequency, chlorophyll-a, carotenoid and c-phycocynin upto moderate exposure (10 mM for 96 hr of Ni treatment). Protein and total non protein thiol were measured as stress responsive metabolites and frequency of heterocyst and spores were observed in responses to Ni. The present study demonstrated that the tested cyanobacterium exhibited dose specific responses of metal towards studied different morphological, physiological and biochemical parameters.

Morphology and cultural behavior of Botryococcus protuberans with notes on the genus.

The green alga Botryococcus protuberans was isolated from its natural environment and its morphology under different cultural conditions was examined. The alga was characterized by a high starch content and reddish oil drops as the assimilatory products. Photosynthetic pigments, Chl a, Chl b, carotenoids and xanthophylls are present. Modification of environmental conditions in modified Chu-10 medium resulted in optimum growth of the alga. Fatty acid composition revealed palmitic acid being the major component, while lauric acid, myristic acid and stearic acid were found in less quantity.

Antiallergic/antiasthmatic effect of novel antiallergic hexapeptide-95/220 in various experimental models.

The effects of newly synthesized antiallergic hexapeptide 95/220 was investigated on various allergic and asthmatic test models. This newly developed peptide was found to be more potent than clinically used drug disodium cromoglycate (DSCG). Hexapeptide 95/220 inhibited immediate hypersensitivity reactions such as passive cutaneous anaphylaxis (PCA) and mast cell degranulation in rats, antigen-induced bronchoconstriction in actively sensitized guinea pigs in dose dependent manner like DSCG. Antigen-induced contraction of guinea pig ileum was also markedly inhibited by this newly developed hexapeptide in the same fashion as ketotifen and DSCG did but at comparatively lower dose. Egg albumin-induced histamine release was also blocked by this hexapeptide from chopped lung tissues of sensitized guinea pigs. These results suggest that hexapeptide' 95/220 has potent inhibitory effect on immediate hypersensitivity reactions thereby inhibiting mediator release from mast cell. Moreover, this newly synthesized peptide is orally active and effective at lower doses as compared to standard drugs.

A multicentric study with arteether in patients of uncomplicated falciparum malaria.

Two hundred and sixty seven patients of uncomplicated P. falciparum malaria completed study in a multicentric phase III clinical trial of Arteether. Arteether was given intramuscularly in a dose of 150 mg daily for three consecutive days. Each patient was followed upto 28 days of alpha, beta arteether therapy. The cure rate was 97% with fever clearance time between 1-7 days (24-168 hours) and parasite clearance time between 1-3 days (24-72 hours). Parasite reappearance rate was found to be 3% and reported at only three of the centres. Following the treatment no adverse effect was observed on haematological, biochemical and vital clinical parameters.

A geometry optimization and molecular electrostatic potential mapping study of structure-activity relationship for some anti-Alzheimer agents.

Molecular geometries of some substituted (pyrroloamino)pyridines which possess anti-Alzheimer activity were optimized and potential-derived CHelpG point charges were computed using ab initio SCF molecular orbital approach employing the 3-21G basis set. AM1 molecular orbital calculations were performed using these optimized geometries and thus optimized Hybridization. Displacement Charges (HDC) combined with Löwdin charges continuously distributed in three dimension were obtained. Molecular electrostatic potential (MEP) maps of the molecules were obtained in two ways: (i) using the HDC-based model with the help of which MEP minima near the molecules were located, and (ii) using the CHelpG point charges, MEP values on the van der Waals surfaces of the molecules were computed. The MEP maps computed using both the methods have negative MEP regions near the pyridine nitrogen atom which appears to be the main binding site of the molecules with the appropriate receptor. Both electrostatic interaction and lipophilic association between these molecules and the receptor appear to contribute to biological activity.

Effectiveness of alpha-beta arteether in clearing Plasmodium falciparum parasitemia in central India (Madhya Pradesh).

Forty-six patients (25 Females + 21 Males) of uncomplicated Plasmodium falciparum in districts Jabalpur and Mandla of central India (Madhya Pradesh) were administered alpha-beta arteether (an ethyl derivative of qinghaosu), intramuscularly for 3 consecutive days (150 mg once a day). The results revealed that there was rapid control of fever in all the patients without administration of any antipyretic drug. The mean parasite clearance time was 30.78 +/- 10.92 hours and recrudescence/reinfection rate was 6.7% within 28 days. Study indicates that arteether, besides being a potent and fast acting schizontocidal drug, also exhibited gametocytocidal action on P. falciparum.

Effects of enalapril on lipid profile in diabetic and non-diabetic essential hypertensive patients.

Effectiveness of enalapril was studied in hypertensive patients with or without diabetes-mellitus. All the patients received enalapril, 5-20 mg per day for 9 months. Enalapril effectively controlled the blood pressure and favourably altered the lipid levels and did not affect the glucose level in diabetics as well as non-diabetics. Enalapril may be considered as a better therapeutic option for the treatment of hypertension associated with diabetes mellitus.

Comparative effects of atenolol versus nifedipine on serum lipids and other biochemical parameters in diabetic and non-diabetic hypertensive subjects.

A controlled clinical trial on 65 patients was performed to compare the effects of nifedipine and atenolol in diabetic and non-diabetic hypertensive patients. Patients were from 45 to 70 years in age. The diabetic hypertensive patients and non-diabetic essential hypertensive patients randomly received atenolol (50-100 mg per day) or nifedipine (10-20 mg per day) for 9 months. Both the drugs effectively controlled the blood pressure throughout the therapy. Atenolol treatment significantly increased triglyceride levels and decreased the HDL-cholesterol levels after 9 months in both groups. However, nifedipine therapy did not alter lipid levels to any significant extent. Both drugs did not alter blood glucose, serum creatinine and blood urea levels. It may be concluded from the present study that nifedipine is preferable to atenolol as it does not alter lipid profile to any significant extent in diabetic and non-diabetic hypertensive patients.