An interprofessional interventional approach to improve the mental well-being of medical students for better academic performances

Background: Medical students are the future doctors who are the primary caregivers for the society. High level of stress can obstruct the learning of medical students by impairing their concentration, problem solving, and decision-making skills. Improving mental well-being of medical students will ensure community safety. The stakeholders need to realize positive role of mental well-being on academic performance of students. This will not only benefit the students as well as the society as a whole. Aim and Objective: The present study was innovatively planned to determine the impact of the motivational sessions on relieving perceived stress and anxiety of the students along-with impact of such sessions on motivation for learning. Materials and Methods: An interventional cross-sectional study was designed for 2nd year MBBS students. A module comprising of eight sessions for improving mental well-being of undergraduate students was designed by an interprofessional team comprising a medical teacher, clinical phycologist, psychiatrist, and medical students. The pre-validated scales used were Hamilton Anxiety Rating Scale (HAM-A) to assess anxiety level, Perceived Stress Scale to assess perceived stress, and Motivated Strategies for Learning Questionnaire to measure the types of learning strategies and academic motivation of college students. Results: About 64% (n = 46) of the participants were male and 36% (n = 26) were female students. The present study showed no significant association between the gender and stress. It was seen that number of students with high perceived stress before the session were reduced by as much as 72.41% and that of students with highest motivation for learning strategies doubled from 18 to 36 (100% improvement).The difference in means of HAM-A scores in post-test and pre-tests is highly significant (P = 0.01). The students were very much satisfied with the mode and content of the module. They expressed that these sessions made them feel thought of and cared for. Conclusion: It is strongly recommended to apply this interprofessional interventional approach to improve the mental well-being of medical students for better academic performances.

Postpartum intrauterine contraceptive device: evaluation of acceptance and complications

Background: Postpartum intrauterine contraceptive device is inserted within 10 minutes to 48 hours of expulsion of placenta. The objective of the study was to determine acceptability, safety and complications of PPIUCD in tertiary care center.Methods: This is a retrospective study conducted at Zenana Hospital, SMS Medical College, Jaipur over a period of 1 year from April 2018 to March 2019. Women were followed after 6 weeks and their complaints and various parameters were analyzed.Results: 5653 women were inserted PPIUCD during 1 year period. Acceptance rate was 29.26% and higher in multipara (54.30%) and between 18 to 25 years of age (50.29%). The main complaints at follow-up were pain and bleeding which were dealt mainly by reassurance. Main cause of removal was bleeding, pain and family pressure.Conclusions: The acceptance was high in this study group. PPIUCD is safe, effective and acceptable with negligible side effects. PPIUCD has abundant scope in India where accessibility for contraception is lower during interval period and women do not come for follow-up after delivery.

Hepatopulmonary syndrome, an unusual cause of hypoxemia.

A six-year-old boy presented with cough, cyanosis and clubbing. Investigations revealed hypoxia (PaO2 53 mm Hg on room air) which was only partially correctable (PaO2 73 mm Hg) with 100% oxygen administered through a non re breathing face mask. Liver function tests showed elevated total bilirubin, and transaminases, liver biopsy confirmed chronic hepatitis and endoscopy showed grade three varices. A contrast enhanced echocardiography (bubble study) revealed pulmonary arterio-venous communication. A diagnosis of hepatopulmonary syndrome was made based on the triad of hypoxemia, liver disease and intra pulmonary vascular communications.

Symbiotic effectiveness of bacteriocin producing and non-producing strains of Rhizobium in green gram (Vigna radiata).

Rhizobium strains nodulating green gram [Vigna radiata (L.) Wilczek] were found to produce bacteriocin on modified Bergersen's medium and inhibited the growth of homologous Rhizobium strains. Four bacteriocin producing and four bacteriocin non-producing strains were compared for their effect on nodulation, in planta nitrogenase activity and plant dry weight of green gram. The bacteriocin producers formed more nodules in comparison to non-bacteriocin producers. However, the symbiotic effectiveness of bacteriocin producers was less in terms of plant dry weight in comparison to non-bacteriocin producers.

Analogue-resistant mutants of Azotobacter chroococcum derepressed for nitrogenase activity and early ammonia excretion having potential as inoculants for cereal crops.

Spontaneous mutants resistant to methionine sulfoximine (Msx), methyl alanine (Mal) and methyl ammonium chloride (Mac) were derived from A. chroococcum strain A103. Msx and Mal-resistant mutants expressed 1.73 to 10.98% of the fully derepressed nitrogenase activity when grown in Burk's medium containing ammonium acetate. Mac-resistant mutants did not express nitrogenase activity in ammonium acetate supplemented medium. The mutants excreted ammonia even after 2 days of growth and some mutants excreted more ammonia as compared to the parent. Selected mutants were inoculated on wheat (Triticum aestivum) and barley (Hordeum vulgare) under field conditions. Majority of the derepressed mutants increased grain yield of wheat and barley varying from 1.2 to 33.3%. However, host-dependent effects on grain yield were observed with different mutants. Two mutants, Mal 27 and Mac 19 showed significant increase in grain yields of both the crops. The results suggest that metabolic analogue-resistant mutants of Azotobacter have potential for use as a biofertilizer for cereal crops.

Rhizobium strains expressing uptake hydrogenase in different host species of cowpea miscellany.

Uptake hydrogenase activity in nodules of green gram (Vigna radiata (L.) (Wilczek)), black gram (Vigna mungo (L.) (Hepper)), cowpea (Vigna unguiculata (L.) and cluster bean (Cyamopsis tetragonoloba (L.) (Taub.)), formed with two Hup+ (S24 and CT2014) and one Hup– (M11) Rhizobium strains, was determined at different levels of external H2 in air atmosphere. Nodules of all the 4 host species formed by inoculation with strains S24 and CT2014, showed H2 uptake but not those formed with strain M11. H2 uptake rates were higher in 1 and 2% H2 in air atmosphere (v/v) than at 5 or 10% levels in all the host species. Variations in the relative rates of H2 uptake were observed both, due to host species as well as due to Rhizobium strains. However, no host dependent complete repression of the expression of H2 uptake activity was observed in nodules of any of the host species formed with Hup+ strains.