Assessment of fatigability, depression, and self-esteem among head-and-neck carcinoma patients in a tertiary care hospital in South India

Background: Head and Neck Carcinoma (HNCs) are the most common form of cancer in India. Patients with head-and-neck carcinomas often suffer from various distressing symptoms. The exact cause of these symptoms, as to whether disease or treatment or other factor induced, needs to be established. Objectives: This study was done to assess fatigability, depression, and self-esteem among HNC study group before start, during, and in postradiation period and to find out the determinants of these parameters. Materials and Methods: Seventy newly diagnosed HNC patients and equivalent number of age- and gender-matched controls were interviewed using standardized questionnaires, before start of concurrent chemoradiotherapy (CCRT). The study group patients were interviewed again in the 4th week and postcompletion of CCRT in the 7th week. Results: Mean age of the study group was 55.1 ± 11.3 years. Three-fourth of them (52 [74.3%]) were males. Majority of them (26 [37.1%]) had oral carcinomas. Baseline fatigue (P < 0.001) and depression scores (P < 0.001) were significantly more, while self-esteem scores (P = 0.004) were significantly less among the study group compared to controls before the onset of radiation. Mean fatigue and depression scores were found to significantly increase (P < 0.001), while self-esteem scores were found to significantly deteriorate (P < 0.001) over the course of CCRT among these patients. There was significant positive correlation (P < 0.001) between fatigue and depression scores and negative correlation (P < 0.001) of these parameters with self-esteem scores before, during, and after CCRT. There was no association between age and gender of the study group with any of these parameters. Multivariate analysis showed that baseline fatigue was significant (P < 0.001) and, depression after completion of the entire course of CCRT was significantly influenced by baseline depression levels (P = 0.011). Conclusions: Fatigue and depression need to be periodically screened among HNC study group on CCRT so as to initiate prompt remedial measures for its alleviation

Proportion of Refractive Error and Its Associated Factors among High School Students in South India.

Background: School children are a high risk population for refractive errors (REs). Uncorrected REs can adversely affect the learning abilities and mental development of school children. Objectives: This cross sectional study was conducted to observe the proportion of cases diagnosed with REs, to determine factors associated with it, to find out the practices of students in preventing these risk factors and to assess the perception towards visual aids among students with REs in schools of an urban area. Methods: This study was done in Mangalore city in February 2013. 482 high school children were interviewed using a structured interview schedule. RE was ascertained based on records of previous diagnosis by Ophthalmologist. Data was analyzed by Chi-square test and binary logistic regression analysis. Results: The prevalence of already diagnosed cases of RE was 94(19.5%). Most of these cases had myopia 92(97.9%). Two cases were of hypermetropia. Mean age of onset of RE was 10.2±2.1 years. Only 19(20.2%) cases were first detected in schools in spite of functioning school health services at all the surveyed schools. RE cases were significantly more in private schools in comparison to government schools (P<0.001). Risk factors significantly associated with RE were history of RE among siblings (P<0.001), inadequate reading distance (P=0.011) and doing homework with inadequate illumination (P=0.021). One third of students with RE were irregular in eye examinations. Conclusion: Proportion of REs was high among school students. Education of students on healthy postural habits and good illumination while studying at home is essential to prevent REs in this population.

Perception towards Problem Based Learning among Medical Students of a Private Medical College in South India.

Introduction: Meeting the changing demands in medical education requires implementation of innovative teaching methods. Problem based learning (PBL) was introduced for the first time for teaching Community Medicine at Kasturba Medical College, Mangalore. The objective of this study was to obtain students’ perception towards this learning experience so as to evaluate its potential benefits. Study Design: Cross sectional study. Place and Duration of Study: This study was done in a private medical college between June to November 2014. Methods: It was conducted among final year medical students. PBL was introduced to a randomly chosen group of students and their perception towards this learning experience was obtained. The assessment was done using a standardized questionnaire containing responses in a five point Likert scale ranging from strongly agreement to strongly disagreement. Results: Mean age of the 54 participants was 21.4±1.0 years. Majority were females 33(61.1%) and were Indians 45(83.3%). Majority of students strongly agreed to most parameters under application of knowledge base, clinical reasoning, decision making skills, self-directed learning and collaborative work experience in PBL tutorials. Similarly feedback regarding standard of PBL exercise, self/peer performance and facilitator performance in the PBL tutorials was strongly agreed to be satisfactory by majority of participants. However 24(44.4%) of them found PBL to be time consuming. Greater proportion of males felt that their contribution was not satisfactory during sessions (p=0.049). Conclusion: Students feedback towards PBL was found to be satisfactory in all aspects. Few barriers like demotivation on the part of male participants needs to be resolved by facilitators so as to improve output in PBL sessions.