ABSTRACT
Introduction: Peak expiratory flow (PEF), exhibit a 24 hour circadian rhythm with nadir in the early morningand peak in the evening. This diurnal variability gets accentuated in asthmatics. Rhythm characteristics ofsuch time series data can be better explained using Cosinor analysis by fitting a cosine curve. Also itmakes easier to compare data even when there is a difference in sampling time points. Data of PEFcircadian rhythms in Indian population with Cosinor analysis is lacking making it difficult to frame guidelineto diagnose asthma.Methods: PEF was recorded from 249 subjects using Wright’s portable Peak Flow Rate meter at 5:00, 8:00,11:00, 14:00, 17:00, 20:00, and 23:00 hours for one day. Cosinor analysis was done and rhythm characteristicswere determined for individual subjects.Results: The mean PEF values after a minimum in morning at 05:00 hours tend to increase throughout theday peaking in afternoon and there is a regular fall in PEF levels after 17:00 hours till 05:00 hours. Meandiurnal variation expressed as amplitude percent mean (A%M)is 8.81±4.8. With Cosinor analysis significantrhythms were detectable in 64% of subjects. For this population MESOR (Midline Estimate Statistic ofRhythm) is 528.49 L/min, Amplitude is 8.2% and acrophase is 15.49 Hours.Conclusion: Results are comparable with the data published in other studies for other populations. Thevariability (amplitude) in normal subjects is lesser than that of smokers and asthmatics. Amplitude andacrophase characteristics will help unifying the data and guide in deciding the cut-off values for diagnosingasthma
ABSTRACT
Background: To evaluate the learning outcomes, objective methods of assessment play an important role.With limited resources in medical colleges, it is difficult to implement objective methods like objectivelystructured practical examination (OSPE). This study is an effort to amalgamate objectivity in conventionaltype of assessment.Methods: 33 students of first MBBS were assessed independently by 3 examiners during practical examination.One examiner awarded marks in conventional manner while two other examiners used semi-structuredassessment taking into consideration the affective, cognitive and psychomotor domain of the students.Linear mixed effects analysis of the relationship between the outcome score and methods of assessmentwere performed using statistical software R. Two models were constructed: first, a null-model without anypredictor and examiners as random effect and second, a full-model with method of assessment as fixedeffects and examiners as random effects.Results: Intra-class-correlation (ICC) was 0.24 in null model and 0.01 in full model. The decrease in variancedue to examiners between the models can be accounted to different methods of assessment. Pearson’scorrelation coefficient between the two semi-structured assessments was 0.754 as compared betweenconventional and semi-structured assessment, which was 0.488 and 0.466.Conclusion: Linear mixed effects analysis of the relationship between the outcome score and methods ofassessment shows the significant effect of types of assessment on the outcome score of the students.Semi-structured assessment is better in terms of validity, reliability, feasibility and applicability.
ABSTRACT
The effect of short term (12 weeks) physical exercise on serum total testosterone level was evaluated in 30 young male adults, aged 18-27 years (mean age 21.67±2.26 years). These medical students, having sedentary life style underwent heavy exercise by attaining heart rate 125-150 beats/min on bicycle ergometer for 15 min on alternate day basis amounted to 670 kilopond metre per minute work done and percentage of VO2max was 71±3. Pre-exercise serum total testosterone levels (5.49±1.31) of students were compared with those obtained after 1 week and 12 weeks of initiation of exercise. The serum total testosterone was measured by DRG Testosterone ELISA kit. After 1 week of exercise, a statistically insignificant decrease (5.488±1.32; P>0.05) was found while after 12 weeks of exercise, a statistically significant increase (6.41±2.28 P<0.05) was noticed between the pre-and post-exercise serum total testosterone levels. We conclude that short-term exercise produces an elevation in serum testosterone levels in young adults.