National Medical Commission Act, 2019 – the need for parity

The National Medical Commission (NMC) has replaced the erstwhile Medical Council of India with the intention of bringing about positive reforms in medical education and enforcing ethical standards in the practice of medicine in India. The NMC Act of 2019, under clauses 3 and 4 of Section 30, details the procedure of grievance redressal. However, these clauses in their current form empower doctors and patients unequally. While the Act empowers an aggrieved medical professional to approach the relevant appellate fora under the NMC, it is silent on a similar opportunity for an aggrieved patient or caregiver to appeal against the decision of a State Medical Council. There is a need to amend these clauses to ensure equitable opportunity for aggrieved patients to appeal against decisions of the State Medical Councils to ensure justice.

Undergraduate Medicine Curriculum in India: Untying the Gordian knot

The medical education system in India is one of the largest in the world. Therefore, the quality of Indian medical education and the physicians it produces has implications on public health at large. Change is the necessity of evolution and growth. In this article, we address the challenges Indian undergraduate medical education faces and attempt to address them. The steps suggested are delineation of goals and objectives of education based upon the need of the country, adoption of innovative digital-based synchronous and asynchronous teaching, both in-person and digital learning methodology (hybrid model), early introduction of clinical postings, family adoption program, shortening the course of MBBS, problem-based learning, adjustments in the course structure, updating of course content, rationalizing assessment strategy, and emphasis on structured and skill-oriented internship.

Monoclonal antibody-escape variant of dengue virus serotype 1: Genetic composition and envelope protein expression

Monoclonal antibody-escape variant of dengue virus type 1 (MabEV DEN-1) was discovered and isolated in an outbreak of dengue in Klang Valley, Malaysia from December 2004 to March 2005. This study was done to investigate whether DEN152 (an isolate of MabEV DEN-1) is a product of recombination event or not. In addition, the non-synonymous mutations that correlate with the monoclonal antibody-escape variant were determined in this study. The genomes of DEN152 and two new DEN-1 isolates, DENB04 and DENK154 were completely sequenced, aligned, and compared. Phylogenetic tree was plotted and the recombination event on DEN152 was investigated. DEN152 is sub-grouped under genotype I and is closely related genetically to a DEN-1 isolated in Japan in 2004. DEN152 is not a recombinant product of any parental strains. Four amino acid substitutions were unique only to DEN 152. These amino acid substitutions were Ser[326]Leu, Ser[340]Leu at the deduced E protein, Ile[250]Thr at NS1 protein, and Thr[41]Ser at NS5 protein. Thus, DEN152 is an isolate of the emerging monoclonal antibody-escape variant DEN-1 that escaped diagnostic laboratory detection.

effect of software upgrade on optical coherence tomography measurement of the retinal nerve fiber layer thickness

To determine the effect of software upgrades on retinal nerve fiber layer [RNFL] thickness measurements taken by spectral domain optical coherence tomography [SD-OCT]. Eighty normal eyes [40 patients] were scanned for RNFL thickness measurements using Spectralis [Heidelberg Engineering, Heidelberg, Germany] SD-OCT. Scan analysis was performed using version 4.0 software and then reanalyzed with version 5.1.3. Student paired t testing and Pearson's correlation coefficient were used for statistical analysis. Average and quadrant RNFL thicknesses generated using version 4.0 and 5.1.3 software on Spectralis demonstrated high correlation [r = 0.955-0.998]. Average RNFL thickness using version 4.0 was 0.08micro m thinner than version 5.1.3 [p = 0.409]. Quadrant RNFL differences ranged from -0.26 to +0.97 microm [p = 0.146-0.915]. Segmentation errors were reduced 33% after the upgrade. Minor RNFL thickness changes may occur after software upgrades in Spectralis OCT. The differences did not reach statistical significance but segmentation errors were improved

Ab interno trabeculectomy

Anterior chamber drainage angle surgery, namely trabeculotomy and goniotomy, has been commonly utilized in children for many years. Its' reported success has ranged between 68% and 100% in infants and young children with congenital glaucoma. However, the long-term success of these procedures has been limited in adults presumably due to the formation of anterior synechiae [AS] in the postoperative phase. Recently, ab interno trabeculectomy with the Trabectome_ has emerged as a novel surgical approach to effectively and selectively remove and ablate the trabecular meshwork and the inner wall of the Schlemm's canal in an attempt to avoid AS formation or other forms of wound healing with resultant closure of the cleft. This procedure seems to have an appealing safety profile with respect to early hypotony or infection if compared to trabeculectomy or glaucoma drainage device implantation. This might be advantageous in some of the impoverish regions of the Middle East and Africa where patients experience difficulties keeping up with their postoperative visits. It is important to note that no randomized trial comparing the Trabectome to other glaucoma procedures appears to have been published to date. Trabectome surgery is not a panacea, however, and it is associated with early postoperative intraocular pressure spikes that may require additional glaucoma surgery as well as a high incidence of hyphema. Reported results show that postoperative intraocular pressure [IOP] remains, at best, in the mid-teen range making it undesirable in patients with low-target IOP goals. A major advantage of Trabectome surgery is that it does not preclude further glaucoma surgery involving the conjunctiva, such as a trabeculectomy or drainage device implantation. As prospective randomized long-term clinical data become available, we will be better positioned to elucidate the exact role of this technique in the glaucoma surgical armamentarium

RT-PCR and its detection limit for cell culture grown bluetongue virus 1 using NS1 gene group specific primers.

RT-PCR was standardised for the detection of bluetongue viral RNA using highly expressed non structural protein 1 gene as the target gene with specific primers targeted to 274 bp of 5' end of NS1 gene. PCR product was consistently obtained in 30 PCR cycles. Further, detection limit of RT-PCR was estimated using serial 10 fold dilutions of BHK 21 cells grown BTV 1. The study suggested that RT-PCR can be used for detection of BTV in Indian conditions with the sensitivity limit of 10 infectious particles of the virus. The study suggested that this technique may be used as a tool for sensitive detection of BTV in carrier/reservoir animals, insect vectors and certification of animals and their germ- plasm for export and import purposes.