How Difficult Is It To Implement A Competency-Based Medical Education In India: The Next Steps?

Background:Medical Council of India is in the revamping mode to align the medical curriculum to the emerging health care needs of the society, by introducing Competency-Based Medical Education (CBME). This new medical curriculum intends toimpartthecompetencies that are needed to produce medical graduates who would function efficiently as Physicians of first contact or basic doctorsin the community. The ECE program would enhance the knowledge, skills, and attitude of the medical graduates if it is implemented. We conducted this study to assess the challengescurrently facedby faculties for the implementation of this new curriculum.Material and Methodology:It is a cross-sectional study conducted at NC Medical College, Israna during the study period was July 2021 to November 2021. The study team regularly scrutinized the data collection process and met periodically to review the study conduct and computing of data. At the end of the study period, the consolidated data were analyzedusing IBM SPSS version 22.Result:A total of 50 teaching faculties, we acknowledged 48questionnairesthat were complete. 96% faculties showed positive and opportunistic be haviourtowards the new curriculum of CBME with constructive ideas but 4% faculties declined.Conclusion:CBME is theparadigm shift in the teaching and learning approach of medical education. Mostof the medical facultymembersare aware of the need and have attained a positive attitude for theapplication of CBME. However significant barriers do exist in the form of manpower, new time mapping and resources which need to be addressed.

Immunological assessment in patients of leukaemia.

In the present study delayed cutaneous hypersensitivity response (DNCB test) and humoral response (by uantification of immunoglobulins) ware carried out in 20 cases of leukaemias. None of the cases was found to be anergic or immunodeficient. In remission also patients showed the normal response.

Lipid peroxidation in leukaemia.

OBJECTIVE: Free radicals have been implicated in the pathogenesis of leukaemias, so the degree of lipid peroxidation was studied as a marker of disease activity in patients of leukaemia. METHODS: Lipid peroxidation product malonyldialdehyde (MDA) was estimated in serum from 30 patients of leukaemia by thio-barbituric acid reaction before and after chemotherapy. There were 10 patients of acute myeloid leukaemia (AML), 5 with acute lymphocytic leukaemia (ALL), 15 with chronic myeloid leukaemia (CML) of which 10 were in chronic stable phase and 5 in blast crisis. Twenty healthy age and sex matched individuals served as control. RESULTS: There was a significant increase in MDA levels in AML and ALL patients and serum MDA levels were higher in the active phase of disease than in remission. We observed a direct correlation between peripheral leucocyte counts and MDA levels. In CML, MDA levels were higher, more so in the patients who were in blast crisis. Patients of CML blast crisis who achieved remission showed a significant decrease in MDA levels as compared to those without remission. CONCLUSION: We observed a significant increase in MDA levels in active phase of acute as well as chronic leukaemia than those in remission. The proposed mechanism for high MDA is that myeloid cells are a major source of superoxide and other oxygen metabolites which lead to lipid peroxidation. MDA estimation in leukaemia can be of help in detecting type of leukaemia, response of therapy, and to predict the chances of relapse.

Alpha tocopherol concentration in serum of critically ill patients.

OBJECTIVE: Alpha tocopherol is the biologically and chemically active form of vitamin E and is the most abundant lipid-soluble antioxidant in humans protecting the cell membranes. Serum concentration of the antioxidant alpha tocopherol was measured in critically ill patients in whom the excessive generation of reactive oxygen species could compromise antioxidant defence mechanisms. METHOD: Alpha tocopherol concentration in serum was measured spectrofluorometrically in critically ill patients admitted in intensive care unit and age matched healthy adults, patients with diabetes mellitus (DM) and chronic myeloid leukaemia (CML) served as control. RESULTS: Alpha tocopherol levels were significantly lower in critically ill patients (p < 0.001) as compared to healthy control subjects and those in two other disease groups (DM, CML) in which reactive oxygen species are reported to be increased. Elderly patients and patients who stayed longer than 8 days had lower plasma concentration of vitamin E. CONCLUSION: These findings indicate that antioxidant defence could be considerably compromised in these very sick patients and vitamin E supplementation may be beneficial in increasing their antioxidant reserve.

Serum malondialdehyde levels in Indian women.

Mean MDA level in the fifty women was 3.41 +/- 0.75 nmol/ml [table: see text]