Flipped pedagogical approach in teaching skeletal muscle physiology for undergraduate medical students

Objectives: Medical teachers need to use different pedagogical approaches to enhance student learning. Students are exposed to the flipped classroom (FC) in addition to the other teaching approaches which may enhance the comprehension, interpretation, and analytic skills of the students. The objective of this study was to compare the test scores obtained after the FC teaching session with the test scores obtained after a traditional classroom teaching session on a topic in skeletal muscle physiology delivered to 1st-year undergraduate medical students. Materials and Methods: Twenty-one 1st-year undergraduate medical students, undergoing a musculoskeletal system module at a private medical college were involved in this study. Students in the flipped pedagogical method were required to read the notes and power-point slides provided in addition to watching the prerecorded lecture videos before class. During the class, there was a topic review session followed by a small case discussion in groups. In the traditional classroom, students were advised to attend the lectures but there were no recorded videos to watch before the session. The effectiveness of the two types of pedagogical approaches was tested through pre-test and post-test using multiple-choice questions. The students’ perception of FC was collected through a semi-structured validated questionnaire. Results: The pre-test mean score was higher for FC (5.48 ± 1.44) when compared to the traditional classroom (3.19 ± 1.4). In our study, the scores from pre-test to post-test in a traditional classroom showed statistically significant improvement (P = 0.0014) but were not statistically significant in the FC. In the flipped pedagogical approach, the difference between mean correct responses for question number 5 (P = 0.031) in pre-test and post-test was statistically significant. There was an improvement in the mean scores in all the eight questions between pre-test and post-tests in the traditional pedagogical method of teaching. About 79.6% of students agreed that they watched all the assigned videos and 78.6% of students completed reading the assigned power-point presentation slides before coming to the FC. About 78.5% agreed to learn more topics in FC format and 78.6% of students agreed that FC was more engaging and interesting in comparison to a traditional class. Conclusion: Our study showed that flipped and traditional pedagogical approaches both enhance student learning

A Cross Sectional, Analytical Study of the Morbidity Pattern among Boys Residing in Social Welfare Hostels in Tirupati Town, A. P..

The role of hostels in the educational advancement of backward classes is long recognized. In closed homes like hostels, the morbid conditions especially infectious diseases like skin diseases and respiratory diseases tend to rapidly spread among others and become difficult to control. There is increased nutritional demand in this age group because of pubertal changes. It has been found that several school children especially from socially backward sections of the community suffer from nutritional health problems as well as other physical health problems. We wanted to evaluate the morbidity pattern among boys residing in social welfare hostels.METHODSThis is a cross sectional, analytical study to determine the morbidity pattern among boys residing in social welfare hostels. This present study was conducted from August 2013 to July 2014 among boys residing in three welfare hostels, one each for scheduled castes, scheduled tribes and backward classes in Tirupati town.RESULTSThe common prevalent morbid conditions found were skin disorders (46.4%), nutritional disorders (43.1%), eye diseases (29.0%), respiratory diseases (15.3%) gastrointestinal diseases (13.6%), ENT diseases (9.5%,), musculoskeletal conditions (1.0%), and other diseases (5.7%).CONCLUSIONSHealth education and increasing the nutritional supplements improve the health of children with regard to personal hygiene and common diseases. Provision of necessary materials like soaps, oils etc., under supervision of hostel staff will go a long way in controlling these infections.

Urinary Schistosomiasis Detected by Chance in India : A Case Report.

Schistosomiasis is a parasitic trematode that is lesscommonly seen in India. The clinical manifestationsrange from acute, sub acute and chronic phases. Agranulomatous type of lesion formed by Schistosomahematobium in the lower urinary tract. We present acase of rare neglected tropical infection in this part ofDakshin Kannada. A 66-year-old man presents withhistory of irritative voiding symptoms, urgency,incontinence, and nocturia of 2 months duration. CTUrogram showed bladder wall thickening. Cystoscopyshowed granuloma in the posterolateral wall of thebladder. Urine microscopy picked up Schistosomahematobium eggs. Bladder biopsy showed chronicinflammatory type of lesion. This is a case of confirmedchronic granulomatous urinary schistosomiasis in anon-endemic region, and successfully treated.Clinicians should become aware of the existence of thisparasite in few pockets in India.

Dermatoglyphic Pattern Differences in Females with Reproductive System Cancers and It’s Scope in Preventive Care

Introduction: Female reproductive system cancers shorten lifespan in women because of high mortality and morbidity. The detection of pre-invasive and micro-invasive stages makes near 100% survival of cancer patients. Dermatoglyphics is the scientific study of fingerprints. Many genes which take part in the control of finger and palm dermatoglyphic development distinguished cancer patients from the general population. It is possible that these genes also predispose to the development of malignancy. Since many investigations are needed to confirm the diagnosis of cancers, dermatoglyphics can be used as a screening procedure for planning preventive care if a specific pattern is known for a cancer. Aims and Objectives: To analyze the prints of different cancers, to analyze the results, compare with controls and observe the differences in main parameters of dermatoglyphic patterns and to determine a specific pattern for specific cancers. Subjects and Methods: This is a prospective, observational and an analytical study started after the approval by Institutional Ethical Committee of S.V. Medical College, Tirupati. The material for the study consisted of finger and palm prints of outpatients and inpatients of the Department of OBG, Tirupati, Cancer Hospital in and around Tirupati, Nellore and Kadapa. The ink prints of each finger and palm were collected and analyzed. Results: Ridge counts, digital patterns and main line formulae observed in different cancers in the present study were analyzed and presented. Mean TFRC was higher in normal group. Greater AFRC was observed in cancer cervix patients when compared to controls. In the present study, there is no difference (p> 0.05) in a-b ridge count among carcinoma of cervix and control group in both hands. Differences of mean atd, tad and tda angles among the groups are not statistically significant (P>0.05).The most common C-main line termination pattern of cancers are U followed by R and then Ab. IV interdigital area of both hands presented less incidence of loop pattern in cancer cases when compared to normal group. Special findings in respective cancers are discussed separately and they are not found in any other literature. Conclusion: There are very limited studies in literature on dermatoglyphic pattern in female reproductive cancers. Though the cost of prints is less, more time and skilled human resources are required for their analysis. Study sample size of controls and cases to be increased. Public should be enlightened about dermatoglyphics. If large number of studies are done and a specific pattern is established for specific cancers, then it becomes cost-effective to people so that a risk is predicted beforehand in any disease and preventive methods can be employed at an early age as the dermatoglyphic patterns do not change in a life time.

The evaluation of the amount and sustain release of antifungal agent clotrimazole incorporated in different polymer matrix in artificial saliva at a pH of 6.2.

Background: Candidiasis in the oral cavity is an opportunistic infections, the most common species involved is Candida albicans. Clotrimazole (CTZ) is the first line broad-spectrum antifungal drug that has been widely used for the prophylaxis and treatment of oral and vaginal candidiasis. It is seen that the effect of drug is better locally as compared to oral intake. The aim of the present study is to find out the quantum release of clotrimazole from the incorporated materials in the artificial salivary medium at the pH of 6.2 and to access the physical properties of the clotrimazole incorporated reliner and tissue conditioner. Methods: The antifungal clotrimazole is incorporated in two types of denture base material used for this study at 2%, 5% and 10% concentration by weight. The release of clotrimazole out of polymer matrix was studied at various pH. The main property of tensile strength of the specimen before and after the chemical release of the clotrimazole was tested. Result: Concentration was maximum on 8th day and uniformly decreased thereafter. The maximum amount of release upto 8th day was 2.52, 4.23, 9.84 mg for 2%, 5% and 10% respectively. Conclusion: Topical release of antifungal agents is more effective than systemic intake, which has adverse effect like renal toxicity and CNS toxicity.

Visual outcome of traumatic cataract in a tertiary care hospital, Tirupati.

Background: The incidence of ocular injuries in India is estimated to be 20.5% affecting mainly those aged less than 40 years and males. Cataract is the commonest complication after ocular injury resulting from either penetrating injuries from sharp objects like stick or thorn or with blunt trauma by objects like stone, cricket ball etc. The present study aims to find out the visual outcome of traumatic cataract cases. Material and methods: This was a cross sectional study conducted among 40 traumatic cataract cases attending outpatient units of SVRR Government General Hospital, Tirupati during July 2014 to June 2015. A predesigned interview schedule was used to collect the necessary information. All patients had undergone Posterior Chamber Intra Ocular Lens Implantation and visual outcome was assessed after 15 days, 6 weeks, 3 months and 6 months. The results were analyzed using MS excel software and Epiinfo 7 version statistical software. Results: It was found that a large majority of the cases were aged less than 40 years (67.5%) and males (62.5%). The most common type of cataract developed was found to be ‘white soft’ type (47.5%). In 52.5% of patients, the time lag between injury and surgery was found to be 1 week to 1 month. It was found that 70% patients had regained vision (>6/18) after surgery. Conclusion: Posterior Capsular Intra Ocular Lens Implantation is highly effective in restoring vision in traumatic cataract cases. The time lag between injury and surgery should be as short as possible for complete recovery. There should be quick referral of traumatic cataract cases to the specialized ophthalmic care units depending on condition of patients.

Prevalence of diabetes mellitus and its association with life style factors among adults in Tirupati, Andhra Pradesh.

Background: The National Urban Diabetes Survey in India (2010) has reported an age standardized prevalence of diabetes to be 12.1%. The prevalence of diabetes mellitus is known to vary with lifestyle factors. Aims and objectives: The present study was conducted to find the prevalence of diabetes mellitus among adults and its association with certain life style factors like current smoking, alcohol intake, saturated fat intake and physical exercise. Material and methods: This present study was cross sectional and analytical study carried out in 900 adults in the age group of 30 years and above during June 2014 to December 2014. A random blood sugar test was conducted among the selected study subjects and the prevalence of diabetes mellitus was estimated using the cut off level of 180 mg% Those subjects who were already known to be diabetics with or without treatment were also classified as diabetics. The findings were analyzed using Epi-info software 7 version (CDC, Atlanta, USA). Results: The prevalence of diabetes mellitus in the present study was found to be 12.4%. Significantly higher proportion of current smoking was found in diabetics (17.0%) than in non-diabtics (6.1%). Current alcohol intake was significantly higher in diabetics than in non-diabtics (8.0% vs 2.4%); current saturated fat (ghee) intake was similar in diabetics and non diabtics (5.4% and 5.5% respectively). Paradoxically higher proportion of physical exercise was found in diabetics (15.2%) than in non-diabetics (5.1%). Conclusion: The prevalence of diabetes mellitus showed significant association current smoking and current alcohol intake.

Study on the availability of physical infrastructure and manpower facilities in sub-centers of Chittoor district of Andhra Pradesh.

The sub-centers (SCs) are under constant criticism for their inability to deliver quality services due to the nonavailability of adequate infrastructure, manpower and supply of drugs.A cross-sectional study was conducted in Chittoor District of Andhra Pradesh to assess the availability of physical infrastructure and manpower in the SCs. A total of 34 SCs were selected by multistage and stratified random sampling technique. The data was statistically analyzed by using Microsoft Excel. The deficiency in the availability of health workers male and female were found to be 67.7% and 27.5%, respectively. The residential facility for health workers was available only in 26.4% SCs. Only 20.6% of SCs had stethoscope and B.P apparatus. The physical infrastructure and manpower availability at the SCs needs considerable improvement as per the Indian Public Health Standard (IPHS). Facilities to conduct the normal delivery and 24-hours emergency referral services need to be addressed at the earliest.

Urethral obstruction due to lobular mesonephric hyperplasia of the vagina--a case report.

The histological finding of persistent mesonephric duct remnants in the uterine cervix and vagina is uncommon and is usually an incidental finding in tissues excised for other reasons. Herein we present a case of lobular mesonephric hyperplasia in a 45 year old woman who presented with vaginal bleeding and difficulty passing urine.

Leiomyosarcoma of the urinary bladder: a case report.

A case of leiomyosarcoma of the urinary bladder occurring in a middle aged lady with immunohistochemical confirmation is presented for its rarity with emphasis on grading of smooth muscle neoplasms of the urinary bladder.

Septic arthritis due to Actinobacillus actinomycetemcomitans.

Actinobacillus actinomycetemcomitans, a gram-negative aerobic bacillus of the family Parvobacteriaceae which is a normal inhabitant of the oral flora, is a rare cause of human infection. We report a case of septic arthritis caused by this organism in an uncompromised child.

Synchronously performed prostatic fine needle aspiration and core biopsies--an appraisal.

One hundred and twenty-six patients underwent fine needle aspiration (FNA) and/or core biopsies of the prostate in a rurally located, non-oncospecialised organisational setting. The procedures were performed by the residents of varying seniority and experience. While a simple core biopsy alone had a greater diagnostic potential, (37/45) FNA was found to be a rapidly interpretable sampling methodology with consequent reduction of waiting period for diagnosis and institution of treatment. The two techniques taken together complemented each other by avoiding repeat biopsies, delaying diagnosis and therapy. In case FNA turned out to be inconclusive, the report on core biopsy would follow soon, unlike in a situation where they are done asynchronously.