Study of perception of online video-based practical classes and face-to-face practical classes among first-year MBBS students-innovation is the way forward

Background: Since the time lockdown was imposed due to sudden outbreak of the COVID pandemic, online classes have been conducted in all teaching institutions which were mostly theory sessions. But online practical sessions have been scarcely conducted and studied. Aim and Objectives: The objectives of the study were to analyze student perception about online video (OLV)-based practical sessions and face-to-face (FTF) practical sessions and to compare them and to apply the results in curriculum planning. Materials and methods: After receiving Research Committee and Institutional Ethics Committee approvals, the research work was carried out in the Department of Physiology, SVIMS, SPMC (W). FTF practical sessions were taken for first year MBBS students during practical hours before COVID outbreak. During COVID lockdown, OLV-based practical sessions were taken for the same first-year MBBS students. The students were asked to fill a questionnaire consisting of 12 questions based on Likert scale rating and 5 open-ended questions, which would capture the student perception about two forms of practical sessions. Results: Statistical analysis by Wilcoxon test showed that students preferred FTF sessions over OLV sessions (P < 0.0001) and responses to open-ended questions revealed that majority of the students preferred a combined approach (80.6%). Conclusions: This study shows that most of the students showed an inclination towards a combined approach which is known as blended learning, where the FTF session is followed by OLV session, and this underscores the need for innovation in teaching skills which would help students get the benefits of both forms of teaching and cater to a range of learning styles.

A comparative study of two small group teaching methods - tutorials and seminar - as a supplement to lecture classes for 1st year MBBS students

Background: Medical schools in India are changing their educational programs and teaching strategies to ensure that students have active responsibility for their learning process and are prepared for lifelong, self-directed learning. Small group teaching (SGT) is one such tool which helps to make learning process student-centered. In this study, we have assessed the effectiveness of SGTs as a supplement to didactic lecture (DL). Objective: The objective of the study was to compare the effectiveness of tutorials versus seminar as a supplement to lecture class. Materials and Methods: In Department of Physiology, SVIMS, Sri Padmavathi Medical College for Women, a DL class on a topic was taken for 150 1st year MBBS students which were followed by tutorials for one half of students and seminar for other half of students on the same topic. It was done for two topics. An assessment was done each at the end of DL, tutorials, and seminar. Students were also asked to fill a feedback questionnaire about the SGTs on a Likert scale. Results: Tutorials showed statistically significant increase in scores in both the topics (6.955 ± 1.83, P = –0.012 and 6.65 ± 1.78, P = 0.006) whereas seminar showed statistically significant increase in only the first topic as compared to DL (6.84 ± 1.77, P = 0.013 and 6.27 ± 2.09, P = 0.25). There was no significant difference in scores between tutorials and seminar. Likert scale showed positive feedback about SGTs and students wanted more such sessions. Conclusions: Since there was a positive response from students regarding SGTs as a supplement to DL, we would like to adopt a mixed approach with SGT as a component of the overall course to ensure knowledge acquisition and retention by the students.

Carrier detection and prenatal diagnosis in families with haemophilia.

BACKGROUND: Haemophilias are the commonest X-linked disorders affecting approximately 1 in 10,000 male births. Detection of carrier women in families with haemophilia and subsequent antenatal diagnosis of confirmed carriers are important services for these patients and their relatives. Over the last 6 years we performed carrier detection and antenatal diagnosis in families with patients of haemophilia A and B. METHODS: During the last 6 years, 159 families with haemophilia A and B were analysed for carrier detection by DNA analysis, using various polymorphic markers of factors VIII and IX genes. The polymorphisms used were intron 18 Bcl I, intron 19 Hind III, intron 22 Xbal and DXS52/St14 of the factor VIII gene and intron I Ddel, intron 4 Taql, 3 Hhal and Residue 148 codon Mnll of the factor IX gene. There were 189 probable carriers (whose carrier status was not known) and 99 obligatory carriers (confirmed carriers by family pedigree analysis) from 102 families with haemophilia A. Of the 57 families with haemophilia B analysed, there were 98 probable and 52 obligatory carriers. All the analyses were carried out by polymerase chain reaction. For antenatal diagnosis, prior to polymorphism analysis, the sex of the foetus was detected by Y chromosome-specific amplification. RESULTS: One hundred and four females were diagnosed as carriers and 63 as non-carriers by the intragenic polymorphic markers in families with haemophilia A. Eighteen women were informative with only the extragenic marker of factor VIII gene. Four women were not informative with any of the markers used. In families with haemophilia B, 37 women were diagnosed as carriers and 34 as non-carriers by the intragenic markers and 34 were informative only with the extragenic markers. Seventeen women were not informative with any of the markers used. Of the 25 antenatal diagnoses performed (20 haemophilia A, 5 haemophilia B) using the same markers as those used in carrier detection, 14 were male foetuses and 11 female as detected by Y chromosome-specific polymerase chain reaction. Eight were affected males and 6 unaffected. Among the females, 5 were carriers and 6 normal. CONCLUSION: Using the above polymorphic markers of factors VIII and IX genes, a diagnosis could be made in the majority of families.

Perinatal outcome of twins in relation to chorionicity.

Twin gestation, a high-risk pregnancy is responsible for 10% of all perinatal mortalities. The high perinatal mortality of twins has been repeatedly stressed over the years. Studies have also revealed difference in the perinatal mortality rates in relation to chorionicity. Thus, a prospective study of 100 twin pregnancies was carried out at our institute to assess the morbidity and mortality of twins in relation to chorionicity and to analyse the factors responsible for the greater loss. The perinatal mortality rate of monochorionic twins was 17.64% and that of dichorionic twins was 8. 88%, which is statistically significant. Birth weight was found to be the most important factor correlating with mortality rates. The higher perinatal mortality of monochorionic twins was largely due to low birth weights (29.3% of monochorionic twins weighed less than 1500 gm as compared to 12.6% of dichorionic twins). Avoidable deaths were comparable in the two twin groups but dichorionic twins showed greater percentage of fresh stillbirths (40%) whereas in monochorionic twins, 50% were macerated stillbirths. Prematurity was another common factor responsible for greater perinatal mortality in monochorionic twins. Monochorionic twins showed increased incidence of discordant growth (34.8%) as compared to that of dichorionic twins (14.08%). The type of placentation did influence the perinatal outcome of twins making its antenatal diagnosis important.

Agenesis of corpus callosum - a rare case.

A case of corpus callosum agenesis associated with a chromosomal structural defect is described.

Prenatal diagnosis of haemophilia: a preliminary report.

BACKGROUND: Haemophilia A is the most common congenital bleeding disorder seen in man, affecting one in 5000 to 10,000 males. Because of the large size and heterogeneity of mutations in the factor VIII gene, direct detection of mutations is not practically feasible, except the recently detected intron 22 inversions. Hence, the indirect method of gene tracking using various polymorphic markers is the method of choice. Using this approach, we have performed antenatal diagnosis in four haemophilia A families. METHODS: The four families included 21 subjects who were used for gene-tracking analysis. Two families had a positive history with more than one member affected, while the remaining two families had a negative history with only one affected son. In all four families, the propositi and their affected relatives had severe haemophilia A with factor VIII:C less than 1%. All were negative for inhibitors. The polymorphic markers used were IVS 18 Bcl I, IVS 19 Hind III and the extragenic DXS 52 St 14 of the factor VIII gene. Prior to polymorphism analysis, the sex of the foetus was determined using Y chromosome-specific primers. All the analyses were carried out by polymerase chain reaction. RESULTS: Antenatal diagnosis in the four families showed three normal male foetuses and one normal female foetus. Two families provided evidence with only IVS 18 Bcl I and St 14 markers. One family provided information with only intron 19 Hind III marker. The fourth family provided information with all three markers. The coagulation parameters were almost in agreement with the results of DNA analysis. CONCLUSION: All three polymorphic markers yielded information. This suggests that these three markers can be effectively used in the antenatal diagnosis of haemophilia A in Indian families.

Predictive value of the nonreactive nonstress test in evaluating neonatal outcome.

High-risk pregnancies were followed up with antepartum foetal heart testing, in terms of perinatal mortality, Apgar score and incidence of caesarian section for foetal distress to look for the significance of a nonreactive nonstress test in 143 cases. The mean sensitivity was 65.64%, mean positive predictive value was 23.12%, and mean false positive rate was 76.87% for the nonreactive test results.