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Background: An extraordinary impact on health-care personnel has been caused by the coronavirus disease-2019 (COVID-19) pandemic, a health-care crisis. Aims and Objectives: Our aim was to assess the effects of a changing lifestyle on anthropometric measurements, blood glucose levels, atherogenic lipid profiles, and blood pressure over the course of a year in Indian healthcare workers (HCWs). Materials and Methods: A prospective study was carried out on 40 HCWs including 23 male and 17 females between the age of 22 and 59 years. The study was conducted in the Department of Physiology and the Department of Biochemistry, Government Medical College, Kathua, UT of Jammu and Kashmir. Informed written consent was obtained from the subjects and ethical clearance was obtained from the Institutional Ethics Committee. Height, weight, waist circumference, and systolic and diastolic blood pressure were measured using standard methods. Body mass index was calculated as weight in kilograms divided by the square of height in meters. Results: The present study found statistically significant increase in systolic blood pressure and statistically significant decrease in mean HDL-cholesterol before and after COVID-19 pandemic in HCWs. Conclusion: The onset of metabolic syndrome and its potential effects could be stopped by early use of preventative interventions in the changed parameters.
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Background: Chronic kidney disease (CKD) is an irreversible deterioration of renal function and cardiovascular disease is the leading cause of mortality in CKD patients. Aims and Objectives: The aim of this study was to assess the pattern of lipid profile among cases of CKD. Materials and Methods: A cross-sectional study was conducted for 1 year covering total 200 cases (males and females) of newly diagnosed or known cases of CKD. Parameters recorded were as follows: Fasting blood sugar, Serum urea (S. Urea), Serum Creatinine (S. Creatinine), and lipid profile. Estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault formula. Results: Mean age was 51.04 years in conservative management patients and 53.20 years in hemodialysis patients. Overall, male-to-female ratio was 1.82:1. S. Creatinine, S. Urea, and eGFR were deranged more in patients on hemodialysis (Group 2). Mean values of low-density lipoprotein (LDL)-cholesterol, very low-density lipoproteins (VLDL), and serum triglycerides (TG) were significantly higher in patients on hemodialysis compared to those on conservative management, while mean high-density lipoprotein cholesterol was significantly lower. Dyslipidemia was more common in female CKD patients (P = 0.02). Conclusion: Dyslipidemia in CKD worsened as patients progressed to severe stages with significant increase in TG, LDL, and VLDL levels in hemodialysis cases in comparison to conservatively managed, confirming presence of atherogenic lipid profile needing early intervention to prevent cardiovascular complications.
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Background: A person’s preferred method of collecting, processing, interpreting, and organizing knowledge is referred to as his/her “learning style” and several models exist to assess one’s preferred learning style. The VARK model that encompasses four sensory modalities, namely, Visual (V), Auditory (A), Read/Write (R), and Kinesthetic (K) provides students with insight into their preferred forms of sensory information perception. Aims and Objectives: The aim of the study was (1) to evaluate the learning styles of medical undergraduates, and (2) to determine the gender-specific relationship between learning style and academic performance. Materials and Methods: A cross-sectional study was carried out for duration of three months, covering 200 MBBS students (males and females both) from all phases of the MBBS. The VARK self-administered structured questionnaire, version 7.8, was distributed among students and their response collected. Results: About 53% of pupils in the current study utilized multimodal learning, while 47% utilized unimodal knowledge. Kinesthetic approach was the most prevalent unimodal approach (22%), followed by auditory (21%). Bimodal was the most common multimodal strategy, accounting for 31% of all multimodal techniques (Audio and kinesthetic together). About 1% were tetramodal (visual, aural, read/write, and kinesthetic), and 21% were trimodal (auditory, read/write, and kinesthetic). There was no statistically significant correlation between gender and learning styles. Conclusion: VARK is a useful tool to collect information about different learning styles. It makes the student as well as the educator aware about different learning style preferences. Moreover, it is better if students in a teaching medical institute are made aware of their preferred learning style.
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Background: Spirituality is recognition of a sense that there is something greater than myself. Physical exercise is any bodily activity that enhances physical fitness and overall health. Music is a universal language to express mind through tone and emotions. Nature is the physical world or the universe. Intelligence is the global capacity of the individual to act purposefully, to think rationally. Emotional intelligence is the ability to understand one’s own emotions and emotions of others. Adversity quotient deals with ability of a person to deal with adversities in life. Aims and Objectives: The present study was designed to study the effect of different interventions on intelligence, stress and cognitive functions. Materials and Methods: The present study was performed on 144 subjects in age group of 30–39 years. Their basal level of intelligence quotient (IQ), emotional quotient (EQ), resilience score (RS), acute stress score (ASS), perceived stress score (PSS), isometric handgrip (IHG), and stroop tests was recorded. The subjects were divided into four groups of 36 each. Four groups were allotted different interventions of spirituality practices, moderate intensity physical exercise, receptive music, and engagement with nature respectively for 1 month duration. Statistical analysis: ANOVA and post hoc tests along with student t-test were used for computing the results. Results: IQ, EQ, RS, ASS, IHG, PSS, and stroop subtests yielded mixed results with four interventions at different levels of significance. Conclusion: Although every intervention had different and positive impact on parameters, overall spiritual practices exhibited better response on parameters.
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Background: With improvement in living conditions in the population and the availability of treatments for various communicable and non-communicable diseases, the life expectancy and consequently the elderly population have increased. Stress leads to mental and physical problems. Aim and Objective: The aim of this study was to assess the effect of stress on muscle functions in the elderly. Materials and Methods: One hundred apparently healthy persons (50 males and 50 females) took part in the study. Perceived stress scale was used to measure their level of stress. Maximum voluntary contraction (MVC) and endurance time were measured with the help of a handgrip dynamometer. Results: The elderly population sample in our study showed a moderate level of stress, but there was no significant difference between the three age groups under study. Conclusion: A significant positive correlation between MVC and stress level was observed in our study subjects.
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Background: The nationwide lockdown due to coronavirus disease pandemic lead to shutdown of medical colleges. Due to which, it was not possible to teach students in classrooms anymore. To continue with their teaching, the option of online classes was recommended. Aims and Objectives: This study was conducted with an aim to evaluate students’ perceptions regarding online lectures. Materials and Methods: This was a cross-sectional, and questionnaire survey conducted among medical college students in Uttar Pradesh, India. Online lectures were delivered routinely using online applications for 8 weeks which was followed by offline regular classes. A pre-approved, pre-validated semi-structured questionnaire containing 13 close-ended multiple-choice questions was distributed through Google forms as well as in person among all the medical students using a non-probability sampling approach after taking their informed consent. The collected data were organized and tabulated using Google spreadsheet and descriptive statistics was used to depict the results. Results: A total of 193 responses were obtained from MBBS students of first and second phase. The mean age of students was 18.73 ± 1.87 years. Mobile phones (63.21%) were the most popular device used by the students to attend classes. More than half of the students (57%) were self-motivated to attend online classes. The major barrier to online learning as reported by 76.68% students was network issues. About 44% students reported lower understanding of subject compared to offline classes. About 70.47% felt online classes to be more comfortable to attend. More number of students either preferred offline method (37.82%) or a mix of both the methods (34.20%). Conclusion: Online lectures are effective teaching method, but they cannot replace classroom teaching. Thus, online teaching serves as add-on to the offline learning.
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Context: COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an emerging pandemic that is rapidly spreading with more than 114 million confirmed cases and 2.5 million deaths by far. Nasopharyngeal swab (NPS) in VTM has been used as the gold standard respiratory specimen for SARS-CoV-2 reverse-transcriptase real-time PCR (rRT-PCR) tests. But now the virus can also be detected in other clinical specimens like bronchoalveolar lavage, sputum, saliva, throat swab, blood, and stool specimens. Aims: The aim of this study was to determine the diagnostic potential of saliva as a sample in comparison to NPS for detection of SARS-CoV-2 by rRT-PCR. Settings and Design: A cross-sectional study was conducted among 256 paired samples (NPS and Saliva) received in the Department of Microbiology, SMS Medical College, Jaipur over a period of 2 months Methods and Material: NPS from individuals were collected in a sterile tube containing Viral Transport Medium™. Before swab collection, whole saliva was collected by spitting from the suspected patient into a sterile container. Both were stored at room temperature and transferred to the diagnostic laboratory within four hours of collection where extraction was done using Perkin Elmer chemagic extractor and rRT- PCR was performed using NIV, Pune mastermix. Results: Sensitivity, specificity, PPV, and NPV of RT-PCR for the diagnosis of COVID-19 in saliva were 84.26%, 100%, 100%, and 54.05%, respectively. The accuracy of detection of COVID-19 by saliva samples compared to the routinely used NPS samples (considered as the standard reference) for RT PCR was 86.72%. Conclusions: Our results show that saliva as a reliable sample type for SARS-CoV-2 detection.
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Leprosy is the oldest disease affecting humankind since ancient times. Despite MDT’s availability for disease curability, vast pockets of multi-bacillary (MB) cases persist in the community. We conducted this study to know the clinico-epidemiological trends of leprosy over four years and five months in this era of the COVID-19 pandemic (C19P). A total of 90 cases were registered; 59 (65.5%) were males, and 31 (34.5%) were females. The majority (69%) of cases were in the 15-45 age groups. Childhood leprosy was detected in 3(3.3%) cases. A history of contact with leprosy patients could be established in 16 (17.8%) cases. The cases comprised 54.5% local inhabitants and 45.5% were migrants. The MB cases 77 out of 90 (85.6%) were in higher proportion than pauci-bacillary (PB) cases. In the clinical spectrum, BL leprosy was most common in 39% of cases, followed by LL and BT leprosy. Thirty-seven (41%) patients were suffering from lepra reactions (LR), and out of them, 59.4% had type 2 reactions (T2R), and the rest had type 1 reactions (T1R). Disabilities were found in a total of 56 (62.2%) cases, and grade 2 disabilities (G2D) were recorded in 25 (44.6%) patients. Ulnar nerve (UN) was most commonly affected nerve in 64.4% of cases, followed by lateral peroneal (LPN) and posterior tibial nerve (PTN). We observed the impact of Covid 19 infection peak C19P in two ways; firstly, during the C19P peak in 2020, there was a drastic fall in total registered cases (TRC) to 4/year against 22/year in pre-C19P with a relative increase in LRs and disabilities. In post-C19P peak periods, not only was there a marked rise in TRC (20/5 months), but LR (50%) and disabilities (75%) also showed a significant rise. A high proportion of MB cases, LRs and disability rates indicate the need for population-based studies and subsequent public health measures for early diagnosis and treatment. Further large sample-sized, in-depth studies can tell the exact impact of C19P on leprosy.
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Background: Digitization of health records and health delivery processes in health care settings may have an impact on the Patient-Physician communication, wait times, that affect the overall patient satisfaction with the health care services. Aim & Objective: We ascertained the effect of digitization of medical case files on the doctor patient relationship (DPR) domain of patient satisfaction at an urban primary health center in India. Settings and Design: Comparative, cross-sectional study in primary health centres. Methods and Material: The patient satisfaction was compared between the patients attending the Public Health Dispensary (PHD) that uses digitized medical case file system and a Civil Dispensary (CD) which follows the conventional paper based medical records, using a Patient Satisfaction Questionnaire (PSQ). Statistical analysis used: Univariate analysis was done by chi-square test and adjusted analysis was done by multiple linear regression. Results: Patient satisfaction in DPR was found to be same between the digitized medical case files based and conventional OPD (p=0.453). Significantly higher overall patient satisfaction was reported in the conventional paper based OPD than the digitized OPD (p<0.001). Conclusions: Patient satisfaction towards the doctor-patient relationship (DPR) was same between paper based OPD and the digitized medical case files based OPD.
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Background: The reaction time (RT) of an organism refers to how quickly it reacts to a stimuli. The rate at which the central nervous system analyses sensory data and then executes it as a motor response is measured by RT. The human body responds to different sensory modalities in different ways and at different rates. This is critical in both routine and emergency situations. Gender, age, physical fitness, level of exhaustion, distraction, and alcohol have all been shown to influence RT. Aims and Objectives: The aims of this study were to compare the visual RT of first phase MBBS and BDS students to red and green colors. Materials and Methods: Following ethical approval, 250 first phase medical students, ranging in age from 17 to 20, were selected, and all participants provided written informed consent. Anand Agencies Pune designed an audiovisual RT gadget that was utilized to collect visual response time (VRT). The unpaired t-test was performed to assess the data statistically. Results: The individuals’ VRT for the colors Red (R) (Mean: 0.199 s) and Green (G) (Mean: 0.218 s) were statistically significant (P < 0.001). In addition, the variance of VRT in men (Mean: [R] 0.192 s, [G] 0.206 s) was significantly greater than in females (Mean: [R] 0.209 s, [G] 0.226 s; P < 0.001). The results were tallied and examined statistically. Conclusion: As a result of our research, we discovered that the VRT for green was significantly greater than that of red. This might be due to the fact that green takes longer to process than red. Males react to stimuli faster than females.
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Background: Handgrip strength is the maximum force produced during a maximal voluntary contraction (MVC) handgrip strength (HGS). The handgrip dynamometer is used to work out upper-body muscles, particularly those in the forearm and hand. HGS is frequently used as an objective measure of upper extremity functional integrity. HGS is a physiological characteristic influenced by a variety of parameters such as gender, age, and body size. Aims and Objectives: The objective of th study was to assess and compare HGS in healthy first-phase male and female medical subjects. Materials and Methods: In a cross-sectional research, 250 healthy 1st-year medical students between the ages of 17 and 20 participated. Maximum HGS was measured using a handgrip dynamometer. The grip strength of the dominant hand was assessed 3 times at minute intervals, as suggested by the American Society of Hand Therapists, with the higher value (in kg) reflecting the maximal HGS for each. Results: In comparison to female subjects (Mean: 31.87 kg), HGS in male subjects (Mean: 41.85 Kg) was statistically significant (P < 0.001). There was a statistically significant difference in height, weight, and body mass index between men and women, despite the fact that there was no statistically significant difference in mean age. Conclusion: Male individuals had stronger grips than female ones. The purpose of this study is to provide a baseline of normative data (control values) among a sample cohort of GMC Jammu medical students. This study, however, was confined to medical students between the ages of 17 and 20. We believe that diverse age groups should be studied.
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Background: High body iron stores have been linked to insulin resistance, metabolic syndrome, and gestational diabetes. Complications of diabetes mellitus are influenced not only by its duration but also by average level of blood glucose, the latter can be monitored by glycated hemoglobin. Aim and Objective: The aim of this study was to study the relationship of serum ferritin and glycated hemoglobin in type 2 diabetes mellitus. Materials and Methods: The case–control study was undertaken on 100 subjects, both males and females; age 35–70 years; categorized into two groups: Group 1 (Cases = 50 patients of type 2 diabetes mellitus [T2DM]) and Group 2 (Controls = 50 healthy, non-diabetic individuals). Results: Fasting blood glucose, serum ferritin, and glycated hemoglobin values were 178.96 ± 37.16 mg/dL, 261.29 ± 76.98 ng/dL, and 9.37 ± 1.44%, respectively, in T2DM cases, while the corresponding values were 95.06 ± 12.68, 90.75 ± 67.53, and 4.81 ± 0.88 in healthy controls. Conclusion: Increased levels of serum ferritin were seen in T2DM and significant correlation between blood sugar and serum ferritin was found.
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Background: Diabetes mellitus type 2 is fast becoming a cause of concern for governments world over and people at large as it has immense socio-economic impact. A diabetic patient usually goes through phases of being overweight, obese, and insulin-resistant before being classified as a patient of type 2 diabetes. Fasting, though practiced for centuries, is a novel approach for delaying progression and possibly reversing diabetes mellitus. Aim and Objectives: The aim of the study is to look for the effect of intermittent fasting on various health parameters in obese type 2 diabetics. Materials and Methods: The study was conducted at a tertiary care facility in Amritsar. Twelve obese volunteers in the age group of 20–60 years with type 2 diabetes mellitus not controlled with metformin alone were included in the study. All the participants were told to follow intermittent fasting protocol of 16:8 for a period of 4 weeks. At the beginning of the study, weight, height, body mass index, waist circumference, waist-hip ratio, fasting blood sugar, and serum insulin, were recorded in each participant. At the end of the 4 weeks period, all the measurements were repeated and compared with baseline values using the student t-test. Results: There was a highly significant decrease in the anthropometric indices and fasting blood sugar as compared to baseline values at the end of the 4-week period without any change in fasting serum insulin levels. Conclusion: There is a favorable effect of intermittent fasting on anthropometric indices and fasting blood sugar levels without any improvement in fasting serum insulin.
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Background: Sida cordifolia Linn. is a well-known medicinal plant which exhibits anti-inflammatory, antioxidant, and sexual properties. It shows good promise in the treatment of male sexual disorders during its pre-clinical studies. Objective: The objective of the study was to assess the spermatogenesis action of aqueous extract of roots of S. cordifolia Linn. in clinical trials. Materials and Methods: The study uses qualitative criteria such as primary and secondary symptoms, and quantitative investigations such as hematological investigations, hormonal analysis, and semen analysis for assessing the therapeutic efficacy of research formulation through placebo-controlled clinical trials on 50 males having lack of sexual desire and non-satisfactory sexual life. Results: Very high inhibition was noticed in respect of primary symptoms such as lack of libido, difficulty in ejaculation or little amount of semen, as well as secondary symptoms such as nausea, body ache, headache, indigestion, loss of appetite, and general weakness in the research group. Lack of any adverse changes in hematological parameters (blood sugar, hemoglobin, ESR, RBC, and WBC) and biochemical parameters (bilirubin, protein, SGPT, SGOT, and ALP) indicates the non-toxic nature of research formulation. The hormonal levels registered a significant increase during the clinical study in research group, especially the testosterone level (8.53%). Semen quality evaluated through sperm count, motility, and morphology showed a significant improvement in research group, suggesting that administration of research drug in cases of stress-related sexual problems protected healthy cells by reduced generation of ROS and helped maintain quality parameters of spermatozoa during spermatogenesis. Conclusion: The research formulation made from roots of S. cordifolia Linn. shows good and significant (P < 0.05) therapeutic efficacy through inhibition of primary and secondary symptoms and enhancement in hormonal and seminal parameters, validating its spermatogenesis effect without any toxic or adverse effects.
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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune condition that primarily targets smallto medium sized vessels in multiple organ systems, with sinonasal, pulmonary and renal involvement being common.The present case study discusses a known case of ANCA associated vasculitis, type 2 diabetes and hypertension, whopresented with altered sensorium and weakness of the left side of the body. Few months before the onset of symptoms,the patient received rituximab injection for treating cutaneous panniculitis and high pANCA titers. MRI of brain and CECTof chest were suggestive of vasculitis and blood culture showed the growth of Burkholderia cepacia. She was treated withbroad spectrum antibiotics and other supportive treatment. Despite all the efforts including ionotropic and ventilatorsupports, the patient succumbed to the infection.
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In the context of the dangerous phenomenon of antimicrobial resistance to the available drugs, we present here the synthesis and evaluation of 7-(2-((substituted phenyl) imino)-2-phenylethoxy)-4-methyl-2H-chromen-2-ones as antifungal agents. Among the compounds, SB-4 was found to be most potent against Candida albicans when compared with the reference drugs Clotrimazole and Terbinafine. The molecular properties of the newly target compounds were performed by online software, and results showed good drug-like properties. The results showed target compounds further optimized as lead compounds as anti-Candida potential.
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Charcot or neuropathic arthropathies are a progressive form of destructive, erosive and generally painless arthropathies.Prevalence of neuropathic joints has decreased globally with reduction in the cases of leprosy and syphilis. However,syringomyelia and diabetes mellitus have emerged as the major causes for upper limb and lower limb Charcot jointsrespectively. Literature evidence shows lack of India data pertaining to these arthropathies. The present study describesa case of polyarticular Charcot in a patient with syrinx and Chiari malformation. The patient history revealed a provisionaldiagnosis of rheumatoid arthritis and Koch’s elbow, and was treated with anti-tubercular treatment (ATT) and diseasemodifying anti-rheumatic drugs (DMARDS). Nervous system examination would have easily led to the diagnosis ofsyringomyelia. The present study also provides a review of Indian literature on neuropathic joints from 2001 to 2019.Diabetes mellitus, syringomyelia, leprosy and syphilis are major etiologies for Charcot joints.
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Vascular anomalies are the commonest developmental disorders. Venous malformations (VM) result due todysmorphogenesis in the development of veins. Most commonly these disorders are localized to skin and subcutaneoustissue. Deeper venous malformation may affect the underlying muscle, bone and joints. Early terminalization of hair andincreased sweating in VM plaque has been rarely reported. The present study deals with the case of a 15-year-old boywho had VM involving skin, subcutaneous tissue and bones with terminal hair and increased sweating over the plaque.Radiological examination showed bone hypertrophy with slow flow channels and phleboliths due to superficial and deepVM. He was treated with ethanol sclerotherapy.
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Background: Fixed dose combination (FDC’s) of ?1-blockers and 5?-reductase inhibitors have commonly been used in patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). This study compared the effect of FDC’s of tamsulosin, alfuzosin and silodosin with dutasteride on quality of life (QoL) in patients of LUTS with BPH.Methods: Ninety-six male patients aged ?45 years diagnosed with LUTS and BPH were randomized to receive FDC’s of dutasteride with tamsulosin (group 1), alfuzosin (group 2) and silodosin (group 3) over a period of 16 weeks. Quality of life was assessed using International Prostate Symptom Score (IPSS) 8th question, BPH impact index (BII) and modified Patient Perception of Study Medication (PPSM) questionnaire.Results: IPSS 8th question score improved significantly by 61.68%, 57.63% and 63.4% in group 1, 2 and 3 respectively. BPH Impact Index score also improved significantly by 62.95%, 60.13% and 61.82% in group 1, 2 and 3 respectively. All the three treatments were found to be similar in improving the QoL. Majority of patients were satisfied with their treatment and wanted to receive the medication again while a small number of patients were neutral with the study medication. None of the subjects was dissatisfied with any of the treatment.Conclusions: All the FDC’s improved QoL and were found to be satisfactory as per patient perception of study medications.
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The word telangiectasia is derived from tel- end, angos- vessels and ectasis- dilatation. Telangiectasia can be primary orsecondary. Connective tissue diseases like systemic sclerosis, dermatomyositis and systemic lupus erythematosus maybe associated with secondary telangiectasias. Systemic sclerosis presents with mat-like telangiectasias over face, handsand rarely oral mucosa. The present study discusses a case of extensive oral telangiectasias without significant sclerosisover face.