Repurcussions of Concurrent Chemoradiotherapy for Head and Neck Cancers

Cancer is a potentially lethal disorder with abnormal cell growth and metastasis, warranting multimodal treatment owing to its diversity and complexity. Head and neck cancers are physically and emotionally devastating disease, with profound impact on the most fundamental activities of the subjects’ daily life such as the ability to speak, breathe, eat, drink, and socialize. The side-effects of radiotherapy and chemotherapy get superimposed on the existing problems and cause new problems resulting in significant morbidity and suffering. Methods: This Prospective Observational study was conducted at the Department of ENT, Southern Railway Headquarters Hospital, Chennai, India. All subjects were evaluated for toxicities using RTOG/EORTC toxicity criteria and Common Toxicity Criteria (CTC). Results: Hypopharynx was the most common site of malignancy observed (31.6 %). Pain (90%) and appetite loss (84.2%) secondary to Mucositis and Xerostomia were the most predominant, serious and lasting adverse effects noted. Subjects also experienced markedly altered smell (63%) and taste (78%). Skin changes and alopecia was observed in all the subjects. Overall treatment duration was prolonged in 78.9% owing to severe toxicities, which necessitated withholding of last few cycles of chemotherapy. Conclusion: Subjects receiving concurrent Chemo-Radiotherapy experience a substantial number of treatment related adverse events, which had considerable effect on their Quality of life.

Study on tooth morphological variations among various ethnic groups of Pakistan

The aim of the study was to elucidate the prevalence of some accessory dental morphological traits variations in permanent teeth of population belonging to Swati, Gujar and Jadoon ethnic groups. The study sample was 300 subjects [100 of each group] volunteer students both male and females aged 12-21 taken in different schools of targeted areas having specifically Swati, Gujar and Jadoon residents. The study period was from July-January 2010. The prepared dental plaster casts were examined for morphological variations such as shoveling, bushman canine, distal accessory ridge and cusp of Carabelli. These traits were analyzed through Arizona state university tooth morphology system. The occurrence rate of each morphological trait was calculated as percentage of total sample size. In results the cusp of Carabelli exhibited maximum expression in Swati group while in Swati and Gujars more shoveling was observed as compared to Jadoons however the Bushmen canine was totally absent in these groups. The dentist should be aware of these dental morphological variations because in actual life the teeth morphology expresses more variations than in textbooks

Role of overlearning in skill retention of Cardiac first response course

Objectives: To assess the effect of over-learning, on retention of skill, in final year students of Punjab Medical college after completing Cardiac First Response [CFR] course

Study Design: Quasi experimental study

Place and Duration of Study: Punjab Medical College, Faisalabad during 2014

Methodology: The study used a quasi-experimental design to compare the final year student's of Punjab Medical College having 60 students in over-learning and the same number in the control group. Experimental group practiced the skills for additional 2 hours amounting to 50 percent overlearning. Both groups completed same MCQ and skills tests after six weeks. Data were analyzed using SPSS version 15 and independent t test was performed for comparison of means of both skill test results

Data Analysis: Analyzed by using statistical software SPSS version 20

Results: In 1st time test the MCQ scores mean was 22.8 [n=60] and 21.92 [n=60] for the experimental group and control group respectively. Test after six weeks [2nd time] resulted in score means of 19.20 [n=50] and 16.15 [n=53] for these groups with p value=.000. The total mean score of the experimental groups' adult skill set was 101.42 [n=50] and that in control group was 97.79 [n=53] with p value=. 008 in the 2nd time test. Important skills like chest compressions showed better retention in the experimental group

Conclusion: Over-learning helps in better retention of procedural skills of CFR course after six weeks of nonuse

Development and validation of stability indicating liquid chromatographic (RP-HPLC) method for estimation of ubidecarenone in bulk drug and formulations using quality by design (QBD) approach

ABSTRACT A novel, accurate, precise and economical stability indicating Reverse Phase-High Performance Liquid Chromatography (RP-HPLC) method, was developed and validated for the quantitative determination of ubidecarenone (UDC) in bulk drug, UDC marketed formulation and UDC loaded cubosomes (CBMs) nanocarriers through Response surface methodology (RSM) design with three factors and three levels was performed to optimize the chromatographic variables followed by forced degradation studies of UDC were performed to detect degradation peak. RP-HPLC separation was achieved using mobile phase consisting of Acetonitrile:Tetrahydrofuran:Deionised water in the ratio 55:42:3 and a flow rate of 1.0 mL/min was optimized with a standard retention time (Rt) of 2.15 min, through experiment. The method was found linear in the concentration range of 5-100 µg/mL with a regression coefficient of 0.999. The limit of detection (LOD) and limit of quantification (LOQ) were found to be 3.04 µg/mL and 9.11 µg/mL, respectively.

Perceptions of oral structured examination: a move from subjectivity to objectivity

Objective: To determine the student and examiner perceptions regarding structured viva in comparison with conventional viva as a method of assessment

Study Design: Quantitative survey

Place and Duration of Study: Anatomy Department of Foundation University Medical College, from July 2014 to Oct 2014

Material and Methods: A quantitative survey was conducted after introducing structured viva voce replacing traditional viva in the first and second year MBBS students. A total of 234 students and 12 examiners selected by simple random sampling filled a questionnaire regarding their perceptions. Their responses for each item were recorded on a like rt scale of 1 to 10. The total score for both types of viva were calculated. The mean of total score with SD for structured and conventional viva were calculated. The statistical significance between means scores of the two vivas were calculated using paired sample t-test

Results: It was found that 88.0% students, and 83.3% examiners preferred structured viva as compared to the conventional viva. The mean scores for structured and conventional viva regarding uniformity of assessment time, structuring of questions, confidence in correct judgment, decreased biases, decreased stress level, uniform coverage of topics, continuity of chain of thought, increase in thinking time and student friendliness were significantly greater for structured as compared to conventional viva. The mean overall score for structured viva was 67.55 +/- 15.02, and for conventional viva was 49.42 +/- 17.27 with a statistical significance of p=0.001. The mean scores perceived by students and examiners for structured viva were not statistically significant

Conclusion: Structured viva was more acceptable by the students as well as examiners due to its increased objectivity and less biases

Impact of 24-hour helpline service for people with diabetes

Objective: To evaluate the impact and effectiveness of 24-hour helpline service in providing information and educating patients about self-management of diabetes

Method: The study was conducted at Baqai Institute of Diabetology and Endocrinology [BIDE], a tertiary diabetes care center, Karachi, Pakistan. People with diabetes attending the outpatient department from November 2012 to October 2014 were included in this study. After providing diabetes education, a helpline number was provided for emergency situations. Calls of registered patients were received by diabetes educators stationed at the BIDE around the clock. Data was collected through specially designed interface of HMS [health management system] in which the current complaint of caller and the advice of educator was recorded

Result: A total of 4842 calls were received. Out of those, 4268 [88%] were made by Type-2 diabetics and 526 calls [10%] were made by Type-1 diabetics. The average age of patients was 47.6 years. Three seventy four calls [7.7%] were received with complaint of Hypoglycemia [72-80mg/dl]. Six hundred and ninety eight calls [14.4%] were received with complaint of hyperglycemia [>200mg/dl]. Insulin dose was adjusted on 935 calls [19.3%]. Calls regarding other special situations such as [insulin handling, technique, medicine information] 2014 [41.6%] were received

Conclusion: Station based 24-hour telephonic helpline service is an effective tool for providing continuous support to people with diabetes and their families, for the self-management of diabetes. It can help in the management of various acute complication of diabetes, thereby preventing unnecessary hospital visits and admission

Frequency of depression among patients with Type-I diabetes in a developing country, Pakistan

Objective: To determine the frequency of depressive symptoms among young people with Type-I diabetes

Methods: This cross sectional study was conducted at Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan from February to December 2015. All People aged between 12-20 years with Type-I diabetes for at least 1 year attending the OPD were included in the study. Information about participants' demographic characteristics, co morbidities and Complications, current treatment and medications were obtained. Acylated hemoglobin [HbA1C] levels were checked in all People. The Center for Epidemiologic Studies Depression [CES-D] scale was used to assess the depressive symptoms in the study participants. A cut off value of >/= 16 was used to screen for depression. SPSS 19 was used to analyze the results

Results: Out of 104 people with Type-I diabetes, depressive symptoms were observed in 44 [42.3%] participants. Depressive symptoms were more frequent in females [28/55, 50.9%]. Depressed people had more episodes of DKA [11/44, 25%], hypoglycemia [12/44, 27.3%] or hospitalization [7/44, 15.9%] in the last six months which were not statistically significant

Conclusion: Depressive symptoms are quite common in people with Type-I diabetes. Health care professionals should consider screening youth with diabetes for depression regularly. Further large scale studies are needed to validate our findings

Fabrication and Evaluation of Ketorolac Loaded Cubosome for Ocular Drug Delivery.

Ophthalmic formulations in terms of eye drops are more frequently used formulation for ocular disorders. But unfortunately this mode of drug instillation into the cul-de-sac of eye shows very poor ocular bioavailability (less than 5%). A large number of carrier systems have been investigated to overcome this problem. In the present study a novel nano-carrier system (Ketorolac loaded cubosomes) is developed and evaluated for the safe and enhance ocular bioavailability. Cubosomes were developed and optimized by utilizing glyceryl mono-oleate, poloxamer 407 and initial drug concentration. Finally developed formulation was evaluated for various In vitro characteristics i.e. particles size, size distribution, shape and morphology, in-vitro release profile, corneal permeation, corneal retention, and ocular tolerance study. The optimized drug loaded cubosomal formulation showed mean particle size, polydispersity index, and entrapment efficiency 127.3±12.23 nm, 0.205±0.011, and 53.27±5.23 %, respectively. Transmission electron microscopic analysis revealed a cubic shape of developed formulation. Further, developed formulation exhibited biphasic release profile. Significant high transcorneal permeation (2.07 folds) and corneal retention (2.24 folds) of ketorolac was observed with cubosomal formulation correspond to Ketorolac solution (p< 0.01). Further safety profile of optimized formulation was evaluated by histopathology of corneal membrane. The developed novel ocular carrier system (cubosomes) might be a promising platform as a vehicle for effective ocular drug delivery.

Cobalt oxide nanoparticles aggravate DNA damage and cell death in eggplant via mitochondrial swelling and NO signaling pathway

BACKGROUND: Despite manifold benefits of nanoparticles (NPs), less information on the risks of NPs to human health and environment has been studied. Cobalt oxide nanoparticles (Co3O4-NPs) have been reported to cause toxicity in several organisms. In this study, we have investigated the role of Co3O4-NPs in inducing phytotoxicity, cellular DNA damage and apoptosis in eggplant (Solanum melongena L. cv. Violetta lunga 2). To the best of our knowledge, this is the first report on Co3O4-NPs showing phytotoxicity in eggplant. RESULTS: The data revealed that eggplant seeds treated with Co3O4-NPs for 2 h at a concentration of 1.0 mg/ml retarded root length by 81.5 % upon 7 days incubation in a moist chamber. Ultrastructural analysis by transmission electron microscopy (TEM) demonstrated the uptake and translocation of Co3O4-NPs into the cytoplasm. Intracellular presence of Co3O4-NPs triggered subcellular changes such as degeneration of mitochondrial cristae, abundance of peroxisomes and excessive vacuolization. Flow cytometric analysis of Co3O4-NPs (1.0 mg/ml) treated root protoplasts revealed 157, 282 and 178 % increase in reactive oxygen species (ROS), membrane potential (APm) and nitric oxide (NO), respectively. Besides, the esterase activity in treated protoplasts was also found compromised. About 2.4-fold greater level of DNA damage, as compared to untreated control was observed in Comet assay, and 73.2 % of Co3O4-NPs treated cells appeared apoptotic in flow cytometry based cell cycle analysis. CONCLUSION: This study demonstrate the phytotoxic potential of Co3O4-NPs in terms of reduction in seed germination, root growth, greater level of DNA and mitochondrial damage, oxidative stress and cell death in eggplant. The data generated from this study will provide a strong background to draw attention on Co3O4-NPs environmental hazards to vegetable crops.

Measured versus calculated LDL-cholesterol in subjects with Type 2 Diabetes

Objective: There is a strong positive association between increased low-density lipoprotein cholesterol [LDL-C] and coronary heart disease [CHD]

The accuracy of LDL-C estimation is essential and critically important. The aim of present study was to compare calculated LDL-C with direct homogeneous assay in patients with type 2 diabetes

Methods: This observational study was carried out at Baqai Institute of Diabetology and Endocrinology [BIDE] from January 2011 to December 2013. A total of 9620 patients with type 2 diabetes were included in the study

Fasting blood glucose, total Cholesterol, triglyceride, HDL cholesterol and LDL cholesterol were obtained using standard methods. Calculated LDL-C was obtained by Friedewald formula

Results: Mean difference of measured and calculated LDL-C was found to be -0.25, 6.63 and 46.55 mg/dl at triglyceride levels < 150 mg/dl, 150 - 400 mg/dl and > 400 mg/dl, respectively

The result shows that the difference between measured and calculated LDL-C increases as the triglyceride level increases

Conclusions: The findings of our study suggested that calculated LDL-C was lower, as compared to measured LDL-C, which may cause misclassifications that may have an impact on therapeutic decisions in patients with diabetes. Calculated LDL-C may depend on triglyceride levels so LDL-C should be measured by direct assay in routine clinical laboratories

Evaluation of S-T resolution by streptokinase therapy in patients of myocardial infarction among the age group of more than 60 years

Objective: To evaluate the benefit and efficacy of streptokinase therapy on ST-segment elevation resolution in different types of myocardial infarction in more than 60 years age group

Materials and Methods:This Hospital based cross sectional study was conducted at National Institute of Cardiovascular Diseases [NICVD] of Karachi, Pakistan. The study included patients more than 60 years of age having different types of myocardial infarction. Fifty patients both male and female fulfilling the inclusion criteria for thrombolytic therapy were included. Baseline ECG was recorded before streptokinase infusion and repeated at completion of infusion, at 90 minutes, day 1 and day 2. Effect of streptokinase therapy [SK] on blood pressure, CKMB, and ST-segment resolution was also evaluated at 90 minutes, day 1, and Day 2

Results: The mean systolic blood pressure was 138.20 +/- 4.57 and 125.20 +/- 3.92 pre and post SK therapy reflecting a percentage decrease of 9.40 and highly significant [P<0.001]. The Diastolic blood pressure was decrease to 9.52% with a mean value of 84.80 +/- 2.46 and 76.80 +/- 1.89 before and after the Streptokinase therapy's, segment resolution at 90 minutes was decreased to 50.69 percent from the baseline and continued to decrease at Day-1 and Day-2 with a percentage reduction of 69.12 and 84.33% respectively. The P values were highly significant [P<0.001]

Conclusion: Thrombolysis when given within 12 hours of the onset of symptoms, improves survival, is beneficial and effective.The magnitude of benefit is greatest when reperfusion is established early. Age itself should not be considered a contraindication for fibrinolysis

To identify the factors affecting the risk of recurrent febrile seizures in saudi children

To identify the risk factors of recurrent febrile seizures [FS] in Saudi children in a Northern Province of Hail in Saudi Arabia. Descriptive prospective study. Pediatric department, King Khalid Hospital Hail, Kingdom of Saudi Arabia from 01 October 2010 to 30 September 2011. A total of 132 children [age ranges from 03 months to 60 months] were included in the study, while they were admitted with the diagnosis of FS during the study period, in the Pediatric department of the King Khalid University Hospital, Hail. A predesigned study proforma was utilized for data collection. All the children included in the study were followed for a period of 01 year after discharge from the pediatric ward for any recurrence of FS. During the study period 132 children were admitted for FS, the mean age of children in our sample was 16 months. There was a preponderance of male children. Among the causes of fever, mostly 63 [47.73%] had symptoms of viral prodrome. Recurrent febrile seizure was found in 46 [34.85%] children. There was a statistically significant association between low temperature at onset of seizure and recurrent FS in 65.22% cases p-value= 0.001]. Similarly, the association of duration of fever [

To study the influence of different grades of Ethylcellulose ether derivative polymer Ethocel[registered] and co-excipient on drug release profile of controlled release matrix tablet of acarbose

The aim of the study presented is to formulate and evaluate Acarbose controlled release matrix tablets by means of different grades of polymer Ethocel and different co-excipients with the intention to see their effects on drug release profile during in vitro dissolution studies. Controlled release dosage forms is gaining rapid popularity due to its positive aspect of reduction in dosage frequency and curtailing side effects. Controlled released tablets of Acarbose were prepared by direct compression method, using Ethocel[registered sign] Standard 7 Premium and Ethocel[registered sign] Standard 7 FP premium polymer. The effect of co-excipients including hydroxypropyl methylcellulose [HPMC], Carboxymethyl cellulose [CMC] and starch on the drug placing 30% lactose were also examined. In-vitro studies were carried out with the help of phosphate buffer [PH 7.4] as dissolution medium. Drug release mechanism was assessed by applying various kinetic models. Similarly / dissimilarity factor f[2]/ f[1] were applied for determination of dissolution profile of the test and reference formulations. Physiochemical characteristics were in the USP satisfactory limits. Conventional Acarbose tablet released 97% of the drug within 2 hrs. Ethocel[registered sign] Standard 7 premium and Ethocel[registered sign] standard 7 FP released 59.9% and 47.01% of the drug within 6 and 99.9% and 97% within 24 hours, respectively. This effect possibly has been aceived owing to the smaller particle size of the Ethocel[registered sign] Standard 7 FP premium which show evidence of anomalous, nonfickian release kinetics. Co-excipients like HPMC, CMC and starch augment the drug release rates from the matrices which may be attributed to their hydrophilic nature. Ethocel[registered sign] Standard 7 Premium and Ethocel[registered sign] Standard premium 7 FP polymers show a promising response in fruitful production of controlled release tablets by direct compression method

Effectiveness of non-mesh [shouldice] versus mesh [lichtenstein] repair in inguinal hernia

To evaluate the optimum method of repair for inguinal hernia with respect to low rate of recurrence, minimum postoperative pain and cost effectiveness. Retrospective and Comparative study. This study was conducted between 2004-2007 in the surgical department DHQ Hospital Karak from. Either 320 patients were randomly allotted to mesh or non-Mesh repair. They were followed up at the 1[st] week and then 1, 6,12,18,24 and 36[th] month. Clinical outcome that is, recurrence rate, quality of life, Post-oparative pain etc were noted. After 3 year, the recurrence rates were significantly different for the two types of repairs. The Shouldice is usually suited in primary and unilateral inguinal hernial repair in adult males. In addition, The Lichtenstein is best for bilateral and recurrent inguinal hernial repair in old patients [>60 Yrs] and in elective states of repair

Influence of oxidative stress in aging on antioxidant levels in healthy male and females

Specific objective of this study was to determine the oxidative stress and anti-oxidant level in aging among 30 to 62 years of healthy male and female of Peshawar City. Descriptive Study. This study was conducted in Jinnah Medical College, Peshawar with collaboration of Faculty of Pharmacy. Gomal University D.I. Khan from January 2013 to May 2014. Total 180 study. Subjects were examined and standardized according to essential parameter of age and sex with no history of any disease and were not talking any medicine with same Scioeconomic factor used for analysis. 90 male divide into three [03] Groups A,B,C and 90 female Subjects was also divide in 3 Groups A,B,C. Serum Ferric Reducing Antioxidant Power [FRAP] assay of Vitamin C, Vitamin E and Glutathione was determined and analyzed. Results were observed with the FRAP values of Vitamin C, E and Glutathione values which are summarized in the table in Show in Figure. Vitamin E, a Secondary antioxidant is very important for generation of other antioxidants. The decrease of value also indicate that define system is deceased during aging the GSH is an important for defense system of the body. Also decreased during aging, specially in old age after 40 years. It is important to use the supplement with diet to fulfill deficiency of their secondary antioxidant

Factors associated with non-adherence to Insulin in patients with Type-1 diabetes

To find out the various factors associated with non-adherence to diet, physical activity and insulin among patients with type 1 diabetes. [T1DM]. This cross sectional study was conducted among T1DM subjects attending the Baqai Institute of Diabetology and Endocrinology [BIDE] and Diabetic Association of Pakistan [DAP], from July 2011 to June 2012.Clinical characteristics, anthropometric measurements, knowledge regarding type 1 diabetes along with adherence to dietary advice, physical activity and insulin were noted on a predesigned questionnaire and score was assigned to each question. Patients were categorized as adherent or non-adherent on the basis of scores obtained. Statistical Package for Social Sciences [SPSS] for windows version 17.0 was used to analyze the data. A total of 194 patients [Male 94, Female 100], with mean age of 17.9 +/- 6.4 years, mean duration of diabetes 5.37 +/- 4.96 years [38.1% > 5 yrs, 61.9% < 5 yrs] were included in the study. One hundred and fourteen [58.5%] patients were non adherent to dietary advice, 82[42.3%] non adherent to physical activity while 88.1% respondents were non adherent to their prescribed insulin regimen. Factors associated with non-compliance were family type, occupation and educational level of respondent's parents, duration of T1DM, family history of diabetes, frequency of visits to diabetic clinic, knowledge regarding diabetes, lack of family support and fear of hypoglycemia. Non adherence to prescribed treatment regimen in patient with TIDM is quite high. There is need to design strategies to help patients and their family members understand their treatment regimen in order to improve their adherence

Time for change: conventional interferon regimes should not be the standard of care for management of Pakistani genotype-3 in chronic Hepatitis C

The aim of the present study was to determine the efficacy and side effect profile of conventional interferon alpha-2b plus ribavirin for treating chronic hepatitis C genotype-3 infections in Pakistan. The study was conducted on treating 220 treatment-naAve individuals at KRL Hospital with conventional interferon given for 6 months. Both the response and side effects were analyzed using simple descriptive statistics. Out of total cohort, 84.92% [169 out of 199] achieved end of treatment response [ETR] while 63.31% [126 out of 199] achieved sustained virological response [SVR]. Leukopenia, gastrointestinal and miscellaneous systemic complaints were the most common adverse effects. In the context of a low ETR and SVR but a similar side effect profile as that of pegylated regimes, conventional therapy needs to be replaced with peg-interferon as the treatment of choice

Iatrogenic post biopsy hemobilia with pseudoaneurysm

Hemobilia is defined as bleeding into the biliary tree from an abnormal communication between a blood vessel and bile duct. It is an uncommon cause of upper gastrointestinal hemorrhage and iatrogenic most of the times. We report a case of hemobilia secondary to percutaneous liver biopsy presenting with classical Quincke's triad in a young lady which was treated with combined biliary balloon sweep thrombectomy and transarterial embolization for complete resolution of symptoms

Postoperative outcome of early oral feeding following elective colonic anastomosis

To assess the safety of early oral feeding after colonic anastomosis. Descriptive case series. Department of Surgrey Lady Reading Hospital Peshawar, from September 2009 to April 2011. Preoperative evaluation included history, physical examination and base line investigations. A limited bowel preparation was done in all the patients. Postoperatively 10-60 ml of sips were allowed 3 hourly after recovery from anesthesia. Free oral fluid intake was allowed on postoperative day-1, semisolids on day-2 and 3 as tolerated and full oral diet allowed on day-4. In case of two episodes of vomiting and absence of bowel sounds, patients were kept nil by mouth and nasogastric tube was placed. Out of total 101 patients, 77 [76.24%] were males and 24 [13.76%] females [M:F 3.2:1]. The age range was from 25 year to 77 year with mean age of 49.5 +/- 2.3 year. The time of passge of first flatus was 2 to 6 days [mean 2.4 days], and the time of first passage of stool was 4-9 days [mean 4.6 days]. Twenty two [21.78%] patients did not tolerate feeding. They developed vomiting and abdominal distension. Postoperative complications included wound infection [7.92%], electrolyte imbalance [4.95%], respiratory tract infection and aspiration pneumonia [5.94%], anastomotic leaks [0.99%] and wound dehiscence [1.98%]. The hospital stay was 3-8 days [mean 5.4 days]. Early oral feeding after colonic surgery was safe and well tolerated by majority of the patients

Searching the way to keep students awake in class room

Team Based Learning [TBL] is gaining popularity as a small group teaching methodology in Medical institutions. Owing to its property of being less resource intensive it is especially useful in developing countries. Students being most important stakeholders need to be focused on research for implementation of the study was conducted to access the students' perceptions as they compare traditional lectures with new methodology in our context. A fifteen item five point Likert's scale questionnaire duly prepared by experts and piloted in students, was distributed among students of fourth year at the end of second module of Team based learning in the subject of internal medicine for fourth year MBBS class and collected after completion. Data was analyzed using SPSS 15. Independent t-test was performed and means were compared for TBL and Lecture methodology. Global rating was also comparedfor both. Total 174 students responded out of which 53 were males and 121 females. 61 students marked "excellent" category in overall rating with preference to TBL by 51 and lectures by 10. Among 121 marking in [good] category 81 were for TBL and 40 for lectures. All fifteen responses in the questionnaires favoured TBL. Comments included [excellent way of retention] for TBL. There was active participation of students throughout the sessions. Students favoured TBL as compared to lectures and therefore TBL is a suitable preferred methodology to incorporate active learning in our undergraduate curriculum