Students’ perspective of the MBBS Physiology curriculum.

Introduction: Rapid technological advances and information overload in the medical field calls for a redesigning of the medical curriculum especially in basic sciences. To incorpate change in the curriculum would require experts’ opinion in the area. At the same time, students’ opinion also forms an important basis for any modification. The present study is small one but it is an important step for this field. We have addressed this issue by evaluating students’ perspective of the physiology curriculum with the help of a semi-structured questionnaire. Aims & Objectives: This study was designed to • Obtain the views of students regarding the curriculum of physiology. • Invite suggestions for improvements. Materials & Methods: The study was conducted at Gian Sagar Medical College, Ram Nagar, Patiala, India using a semi-structured questionnaire. The questionnaire was given to 2nd professional MBBS students, were exposed to of basic science for further training. Results & Discussion: Our study has revealed students’ opinion about certain aspects of the existing physiology curriculum. The students emphasized that they wanted to learn only the clinical application oriented subject content and they the preferred interactive teaching methods. Most students felt the need to reemphasize these subjects in later clinical years. Their assessment is the crucial factor on how they would organize their learning. There is a need for modification in the existing curriculum though similar studies over longer duration of time should be conducted in other medical colleges to recommend changes.

Age related changes in postural stability.

Postural instability is a commonly encountered problem in elderly population. In a large number of persons this can be attributed to the physiological changes associated with aging. To investigate the changes in postural stability with aging this study was conducted in 64 healthy volunteers aged eight to seventy years using dynamic posturography. Three tests, namely sensory organization test, limits of stability and rhythmic weight shift which included a total of ten parameters were done. Of these, equilibrium score, strategy score, reaction time, movement velocity and on axis velocity showed statistically significant deterioration with progression of age. Disturbances in postural stability were detected from the fourth decade onwards in the population studied. This instability was not related to any disease process and possibly reflects the process of aging. Adequate precautionary measures should be taken by elderly persons to avoid the possible adverse consequences of postural instability.

Gender specificity of sucrose induced analgesia in human adults.

Sweet, palatable substances such as sucrose are reported to calm infants undergoing routine investigative procedures. The analgesic effect persists in pre pubertal children and adults with a hint of gender dependent variation in the analgesic response. The present study was therefore designed to explore gender specificity of sucrose induced analgesia in adult volunteers utilizing the nociceptive flexion reflex, an objective tool for pain assessment. Nociceptive flexion reflex was recorded, both before and after (up to 15 min) ingestion of 100 ml of 25% sucrose solution in 6 male and 6 female volunteers. In the male volunteers the maximum amplitude of the response was 20.8 +/- 7.7 microV before sucrose ingestion and 22.6 +/- 9.1 microV, 6.6 +/- 0.7 microV, 6.2 +/- 1.1 microV, 7.5 +/- 0.9 microV at 0, 5, 10 and 15 minutes post sucrose ingestion respectively. In female volunteers, the maximum amplitude of the response was 33.7 +/- 17.7 microV before sucrose ingestion and 43.6 +/- 17.2 microV, 7.1 +/- 1.2 microV, 25.9 +/- 16.1 microV, 50.6 +/- 16.3 microV at the same time intervals post sucrose ingestion. The maximum amplitude values were significantly lower in the males at 10 and 15 minutes after sucrose ingestion (P < 0.05). This is the first objective report of gender specificity in sucrose induced analgesia in adult humans. The gender dependent variation in sucrose induced analgesia is prolonged in male (15 min) and short lived in female (5 min) volunteers. This knowledge may have important implications in pain management.

Antinociceptive effect of sucrose ingestion in the human.

Sucrose ingestion has been shown to alleviate pain and distress in rats, human infants as well as adults. Sucrose induced analgesia is related to the reward value associated with its sweet taste. The sweet taste of sucrose is a stimulus for the activation of endogenous opioid pool. The opioids in turn modulate pain perception. It has been demonstrated in a number of animal and human studies that sucrose ingestion increases the hypothalamic/CSF opioid levels. This gains support from the results obtained from naloxone challenge test, a neuro-endocrine method for assessment of endogenous opioid tone. Moreover, the analgesic effects of sucrose can be reversed by administration of opioid antagonists such as naloxone. On the other hand, long-term sucrose ingestion leads to hyperalgesia in rats and it has been hypothesized to result from a complex interaction of sucrose with the endogenous opioid system leading to a deficiency of opioids. In the present article mechanisms underlying sucrose induced analgesia including the interaction of the palatability and reward value of food with the neural substrates and its neuro-chemical basis have been reviewed in the light of both animal and human studies. In addition, clinical application of the knowledge about sucrose and its modulatory effect on the endogenous opioid system has been suggested.