Assessment of Mental Wellness Amongst the Faculty and Students of an Educational Institute in the State of Himachal Pradesh, India — Post Lockdown during COVID-19

Background: The COVID-19 pandemic had a significant effect on the mental health of human beingsworld wide. There is a lack of information pertaining to the mental wellness of students and faculty in dental institutions in India. This study aimed to assess the overall mental well being of students and faculty of dental institution after return to normalcy post-lockdown period during COVID-19. Material & Methods: A self reporting online questionnaire was designed by the authors after speaking with various therapists and mental health coaches. This questionnaire was anonymously filled out by 492 participants which included under graduate students, post graduate students, academic staff, paramedical and clerical staff in a dental institution. Results: Majority of the subjects felt the need for counseling in their work place (53.4%). A greater number felt they were getting insufficient sleep (48.3%) and (31.5%) of the participants experienced depression and anxiety which further affected their emotional well being and their day to day activities. One-fifth (16.8%) of the participants perceived that mental health affected their relationships and 20.1% observed that physical health restricted their day to day activities. Mental wellness of females was significantly more affected than males. Additionally marital status also influenced the mental wellness of the subjects. Conclusion: Literary evidence suggests that mental wellness is not given enough importance in our country in general. This study only proved the ramifications of COVID-19 on mental wellness and suggested the provision of counselling which could’ve protected the participants from slipping into a negative frame of mind.

Knowledge about COVID-19 Infection and Stress Levels among Ambulance Drivers during COVID-19 Pandemic — A Cross Sectional Study

Introduction : The medical personnel especially have to deal with both the Biological and Psychological consequences originating from the influence of virus. Emergency Care Units equipped with ambulance service always should be at the fore front to face all emerging untoward incidents. Ambulance Drivers often disregard their physical health and mental stress in order to fulfil the duties entrusted on them. Methodology : Cross-sectional questionnaire based on-line survey was conducted. Ambulance drivers were North and South India were taken as study subjects. Knowledge based questions and mental stress were assessed using Perceived Stress level Scale (PSS). The questionnaires were translated toTamil, Kannada, Telugu, Malayalam and Hindi languages. Chi-square test was done to find the association between variables. Results : Among the 101 respondents, 84.2% were having good knowledge about the pandemic. Statistically significant association between number of patients transported per day and the knowledge levels of Ambulance drivers was found (p =0.048)(Chi-square value=15.65). Drivers in Government sector were having more knowledge compared to private sector (p =0.038)(Chi square value=6.53). The perceived mental stress was found to increase with a greater number of patients being transported per day, which was statistically significant (p =0.001)(Chi-square value= 30.42). Conclusion : Knowledge regarding COVID-19 virus was adequate among the Ambulance Drivers. Knowledge was found to be more among drivers who work in Government medical establishments. Mental stress was more among drivers who transported more than 5 patients per day.

Household symptomatic contact screening of sputum smear positive tuberculosis patients at the DOTS clinic of SGT hospital, Gurugram

Background: Contact screening was conducted under ICMR (REFERENCE ID: 2019-07811) programme in villages near SGT hospital, Gurugram. Objective: To evaluate risk factors, extent of spread of tuberculosis among household contacts of tuberculosis cases and to create awareness. Methods and Material: Address of TB cases were taken from RNTCP register at DOTS clinic, SGT medical college. Then all household contacts of positive cases were screened, counselled and advised to approach ASHA Workers if such symptoms appear. Data was analysed using appropriate statistical methods. Results:21 Index cases along with 94 household contacts were screened. 61.90% families still use chullahs for cooking. 76.1% families have overcrowding. 3) 61.90% families had inadequate ventilation 4) 19.05%families were aware about the spread of this disease. 5)Only 23.80% families practised adequate sanitation methods and precautions6) 42.8% Index cases had a history of smoking. 7) 44.4% 4 continue to smoke with infection. The association of adequate sanitation with presence of awareness was found to be statistically significant. (p-value<0.05). Other factors were not significantly associated with level of awareness regarding prevention of tuberculosis spread among study participants. Conclusions: Contact screening is an effective tool and it gives the real-time picture of TB in India.

REMDESIVIR IN PATIENTS WITH ACUTE OR CHRONIC KIDNEY DISEASE IN COVID-19 AND IMPACT ON LIVER AND KIDNEY FUNCTION

Introduction: Acute Kidney Injury is commonly present in Covid-19 hospitalised patients whereas chronic kidney disease and end-stage renal disease are also common comorbidities in patients who develop severe COVID-19. These patients require antiviral medication as early as possible but there is no current guidelines for use of Remdesivir therapy in these patents and drug is not used initially in these patients. Antiviral strategies are desperately needed in this population to treat these patients as early as possible. Material And Methods: We conducted an observational, retrospective cohort study of adults with COVID-19 confirmed by RT-PCR who had eGFR < 30mL/min/1.73m2 or received RRT prior to receiving at least one dose of Remdesivir. eGFR was estimated from the serum creatinine value just prior to the first dose of Remdesivir using the Chronic Kidney Disease Epidemiology Collaboration calculator. The majority of patients requiring supplemental oxygen were offered Remdesivir; eGFR cut-offs were not used as a strict exclusion criteria. All patients with eGFR < 30mL/min/1.73m2 who received at least one dose of Remdesivir in hospital were included in the study. AKI was defined as at least a 1.5- fold rise in creatinine from baseline per KDIGO criteria. CKD was defined as eGFR < 60mL/min/1.73m2 between 7-365 days prior to admission. Patients with “stable CKD” did not meet criteria for AKI at the time of starting Remdesivir. ESRD was defined as requiring RRT > 3 months prior to hospitalization. The primary objectives were to describe changes in ALT, AST, and Bilirubin and serum creatinine during Remdesivir therapy, and to report adverse effects attributed to Remdesivir. A Results: total of 41 patients with eGFR <30 ml/min per 1.73 m2 at the time of Remdesivir initiation were included in the study. 27 patients were in intensive care, and 14 patients were mechanically ventilated at the time of Remdesivir initiation. At the time of Remdesivir initiation, 30 patients were receiving RRT. 11 patients with eGFR <30 ml/min per 1.73 m2 were not on RRT at the time of starting Remdesivir. Four patients developed ALT more than the upper limit of normal and only two patients developed ALT more than 5 times, that may be contributory to other factor also. In general, limited information is available Conclusion: on the impact of SARS-CoV-2 infection in patients with eGFR less than 30. Impact of Remdesivir on these patients and their liver and kidney functions are not well studied. Although the available clinical data are limited, but it shows that impact of Remdesivir on liver and kidney function in patients of eGFR less than 30 is limited. However further studies are needed

Indian Academy of Pediatrics Revised (2021) Guidelines on Prevention and Treatment of Vitamin D Deficiency and Rickets

Justification: The emerging literature on prevalence of vitamin D deficiency in India, prevention and treatment strategies of rickets, and extra-skeletal benefits of vitamin D suggest the need for revising the existing guidelines for prevention and treatment of vitamin D deficiency in India. Objectives: To review the emerging literature on vitamin D prevalence and need for universal vitamin D supplementation. To suggest optimum vitamin D therapy for treatment of asymptomatic and symptomatic vitamin D deficiency, and rickets. To evaluate the extra-skeletal health benefits of vitamin D in children. Process: A National consultative committee was formed that comprised of clinicians, epidemiologists, endocrinologists, and nutritionists. The Committee conducted deliberations on different aspects of vitamin D deficiency and rickets through ten online meetings between March and September, 2021. A draft guideline was formulated, which was reviewed and approved by all Committee members. Recommendations: The group reiterates the serum 25- hydroxy vitamin D cutoffs proposed for vitamin D deficiency, insufficiency, and sufficiency as <12 ng/mL, 12-20 ng/mL and >20 ng/mL, respectively. Vitamin D toxicity is defined as serum 25OHD >100 ng/mL with hypercalcemia and/or hypercalciuria. Vitamin D supplementation in doses of 400 IU/day is recommended during infancy; however, the estimated average requirement in older children and adolescents (400-600 IU/day) should be met from diet and natural sources like sunlight. Rickets and vitamin D deficiency should be treated with oral cholecalciferol, preferably in a daily dosing schedule (2000 IU below 1 year of age and 3000 IU in older children) for 12 weeks. If compliance to daily dosing cannot be ensured, intermittent regimens may be prescribed for children above 6 months of age. Universal vitamin D supplementation is not recommended in childhood pneumonia, diarrhea, tuberculosis, HIV and non-infectious conditions like asthma, atopic dermatitis, and developmental disorders. Serum 25-hydroxy vitamin D level of >20 ng/mL should be maintained in children with conditions at high-risk for vitamin deficiency, like nephrotic syndrome, chronic liver disease, chronic renal failure, and intake of anticonvulsants or glucocorticoids.

Predictive Performance Of Different Diagnostic Criteria For Overweight And Obesity Between 2008-2015 In Adolescents

Background: The reference cut-offs for overweight and obesity have evolved from the use of International obesity task force (IOTF) to extended IOTF and revised Indian Academy of Pediatrics (IAP) growth charts. Methods: Secondary analysis of anthropometric data of school-going children from Delhi in the year 2008, 2013 and 2015 was performed. The proportions of children with overweight, obesity, and undernutrition were checked for agreement using different diagnostic cutoffs, and compared at three-time points. Results: Among 8417 adolescents, weighted Kappa statistics showed good agreement between extended IOTF and IAP cutoffs (k=0.933; 95% CI 0.93-0.94), between eIOTF and IOTF (k=0.624; 95% CI 0.619 - 0.629) and between IAP and IOTF (k=0.654; 95% CI 0.645-0.662). A higher proportion of adolescents were diagnosed with obesity with extended IOTF and IAP charts than IOTF charts (P<0.001 for both genders). The mean (SD) BMI showed a rising trend for adolescents overall from 19.61 (3.89) kg/m2 in 2008, 20.44 (4.37) kg/m2 in 2013 and 20.88 (4.60) kg/m2 in 2015 (P<0.001). 158 adolescent (97 girls) were undernourished using combined IAP and extended IOTF criteria. Conclusion: Both extended IOTF and IAP charts showed good agreement for diagnosing overweight and obesity in adolescents. A secular trend in malnutrition was observed in adolescent girls.

Assessment of Disease Activity in Rheumatoid Arthritis: A Comparative Study of Clinical and Laboratory Evaluation with Musculoskeletal Ultrasonography Assessment

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease and musculoskeletal ultrasonography (USG) is gaining popularity for assessing the disease activity bed side, objectively and cost effectively. There is paucity of such studies from India which establish the correlation between RA disease activity and musculoskeletal USG. Objective: The objective of this study was to compare the disease activity scores in RA patients, assessed by ‘clinical and laboratory evaluation’ with ‘musculoskeletal ultrasound scoring of the affected joints. Methodology: It was a cross sectional study conducted from December 2015to May 2017. We enrolled the diagnosed patients of RA, having at least one USG assessable joint with definite clinical synovitis. Disease activity was assessed by swollen joint count, tender joint count, Clinical Disease Activity Index (CDAI), Disease Activity Score (DAS) 28 ESR and DAS 28 CRP. Musculoskeletal USG was performed by experienced radiologist. Grayscale scores (GSUS) and Power Doppler scores (PDUS) were calculated in 22 joints as per SONAR criteria and each joint was examined as per standardized score. Results: Our study showed that DAS 28 CRP, DAS 28 ESR, CDAI, tender joint count and swollen joints count had positive correlation (p<0.001) with various musculoskeletal USG scores, whereas ESR and CRP failed to show any significant correlation. Conclusion: GSUS-PDUS can be used for diagnosing joint space narrowing, joint effusion, and synovial thickening. PD may become a cost-effective alternative to gadolinium enhanced MRI. Strong correlation exists between USG and physical examination of joint swelling as well as disease activity scores in RA patients.

Assessment of awareness of common rheumatological diseases amongst final year medical undergraduate students: single centre questionnaire-based survey

Background: Assessment of awareness of common rheumatological diseases amongst final year medical undergraduate students – single centre questionnaire-based survey.Methods: A cross-sectional survey of final year students was conducted during a national undergraduate medical summit. Participants were asked to fill out a 10-question survey (online link/in print). Results were summarized using descriptive statistics.Results: A total 162 medical students completed the survey. Only 18 of 162 respondents were able to score more than 50% in all domains with only one respondent getting all the questions correct. Partial awareness about the major rheumatological diseases in adults was seen with 122 (75%), 110 (68%) and 105 (65%) students having more than 50% correct in the domains of lupus, psoriasis and rheumatoid respectively without scoring completely. By contrast even general awareness of pediatric rheumatology was low with only 34 respondents (21%) having more 50% score in this domain.Conclusions: These findings are consistent with the general consensus amongst rheumatologists that medical students are inadequately exposed to rheumatological disorders and evolving treatments. Awareness of paediatric rheumatology is the lowest and needs urgent addressing.

Comparison of plasma adipocytokines & C-reactive protein levels in healthy schoolgoing adolescents from private & government-funded schools of Delhi, India

Background & objectives: Obesity-mediated chronic inflammatory state is primarily governed by lifestyle and food habits in adolescents and marked by alterations in the level of various inflammatory markers. This cross-sectional study was aimed to compare the inflammatory status of healthy Indian adolescents vis-�-vis their obesity profile. The inflammatory state of urban adolescents attending private and government-funded schools, and the relationship between inflammatory marker levels and anthropometric indices in the study participants from both groups were examined. Methods: A total of 4438 study participants (10-17 yr) were chosen from various schools of Delhi, India, and their anthropometric parameters were measured. Plasma adipocytokines (adiponectin, leptin and resistin) of the study participants were measured by enzyme-linked immunosorbent assay, and plasma C-reactive protein (CRP) levels were assayed by a biochemical analyzer. Metabolic syndrome-related risk factors such as waist circumference, hip circumference (HC), fasting glucose, fasting insulin, Homeostatic Model Assessment of Insulin Resistance, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol and triglycerides of normal-weight adolescents were also evaluated. Results: The level of leptin and CRP increased with increasing adiposity, whereas adiponectin levels were found to be negatively related to obesity. All plasma cytokine levels (adiponectin, leptin and resistin) were significantly elevated in female than male adolescents. Age-based classification revealed a distinct trend of variability in the levels of all the inflammatory markers among adolescents of varying age groups. Significant differences were observed between private and government schoolgoing adolescents in terms of anthropometric and inflammatory parameters, with higher adiposity indices in the former group. The relationship of plasma adipokine and CRP levels with various adiposity indices was found to be distinctly different between private and government schoolgoing students. Interpretation & conclusions: Inflammatory markers were significantly elevated in overweight/obese adolescents. The socio-economic condition of urban Indian schoolgoing adolescents reflecting lifestyle transition has profound effects on their adiposity indices and inflammatory states. Longitudinal studies in different regions of the country need to be done to further confirm the findings.

Outbreak investigation of acid fly attack among residential students in a tertiary care centre in South India

Paederus dermatitis is the skin irritation resulting from contact with the haemolymph of certain rove beetles, a group that is comprised by the genus Paederus. In May 2018, there was an increase in the number of residential students reporting with burning skin lesions. In this context, an outbreak investigation was conducted. A team of public health specialists visited these residential buildings and premises. The inmates who were affected were interviewed and examined. Suspected insects were collected and entomologically evaluated by the Zoological Survey of India. On examination of the affected individuals, it was observed that the rashes were very much suggestive of acid fly toxin induced lesions. Inspection of the premises, revealed small heaps of dried leaves with moisture at two sites which could have served as a suitable environment for acid fly multiplication. Our study concluded that Paederus fuscipes as the causative agent. Top storeys of buildings, illuminated at night, facing potentially wet areas were considered to be the potential risk factor. Fly proofing of the building, cleaning the institution premises and chemical treatment was suggested as appropriate control measures.

Comparative Study of Metformin and Combination of Metformin and Sitagliptin in Type II Diabetic Mellitus Patients

Metformin is recommended as initial monotherapy for treatment of type 2 diabetes mellitus because it decreases the higher blood glucose by suppressing hepatic production of glucose, apart from suppression of hepatic glucose production, it also increases sensitivity of insulin, it also enhances the peripheral uptake of glucose (by inducing GLUT4 enhancer factor phosphorylation), and it also decreases the insulin-induced suppression of fatty acid oxidation. The aim of this study, metformin and combination of metformin and sitagliptin in type ii diabetic mellitus patients. Methods: Two groups were included in this study. Each group has 50 cases & each case was having diabetic mellitus. This study conducted in the Career Institute of Medical Sciences in the Department of Pharmacology. The duration of study was over a period of six month. Results: In our study we were included two groups. Each group has 50 cases, means total 100 cases were included. In group I we were observed 26 male & 24 female out of 50 cases. In group I we found that 13 had vomiting followed by diarrhea, metallic taste, abdominal pain. While in group II we found that 3 had vomiting followed by diarrhea, metallic taste, abdominal pain. Conclusion: The foregone discussion revealed that in patients who are on monotherapy with metformin alone having inadequate glycaemic control. The addition of one daily dose of Sitagliptin 100 mg is the most effective way of maintaining glycaemic control.

Evaluation of new non-invasive & conventional invasive methods of haemoglobin estimation in blood donors

Background & objectives: The non-invasive method of haemoglobin (Hb) estimation has unique advantages of exemption of finger prick and associated pain, over invasive methods. This study was done to compare invasive and non-invasive methods of Hb estimation in blood donors keeping haematology analyzer (HA) as a reference method. Methods: The blood donors selected or deferred on the basis of CuSO4method (Hb ?12.5 g/dl), were included in the study. Hb values of the donors were estimated by HemoCue and then by OrSense methods. An immediate post-donation venous sample was drawn for analysis on HA. Results: The mean Hb value was 13.98�27 g/dl on HA, 14.87�03 g/dl on OrSense and 15.03�31 g/dl on HemoCue. CuSO4, HemoCue and OrSense demonstrated sensitivities of 18.7, 18.7 and 13.1 per cent, positive predictive values (PPV) of 64.5, 83.3 and 60.9 per cent and specificities of 98.9, 99.6 and 99.1 per cent, respectively. The intra-class correlation coefficient for OrSense was 0.726 while that for HemoCue was 0.851. Bland-Altman plots demonstrated 2SD difference of >2.0 g/dl in Hb estimations between HA and HemoCue/OrSense. Interpretation & conclusions: The non-invasive modality may provide the near-ideal pre-donation Hb screening platform if an improvement can be done in the sensitivity and PPV of the non-invasive method keeping in view its unique advantages.

To Study Association of Sociodemographic Factors with Awareness and Practices Pertaining to Complementary Feeding in Six Months to Two Years old Child Attending Immunization Clinic in a Tertiary Care Hospital of a Medical College in Urban Area

National Guidelines on Infant and Young Child Feeding should become an integral part of nation-wide Integrated child development Services (ICDS) and the Reproductive and Child Health (RCH) Programme. These need to be effectively operationalized through the programme managers and field functionaries of these on-going programmes. This can happen only when they are practically oriented to the correct norms of IYCF. Methods: A cross sectional study of complementary feeding practices amongst mothers of children aged six months to two years in an urban setting. The place of study is an immunization clinic in a tertiary care hospital of a medical college located in urban area. Study population comprised of mothers of children aged six months to two years attending an immunization clinic. Study was approved by college Institutional Ethics Committee. Mothers who met the inclusion criteria, attending the immunization clinic, from the selected tertiary care hospital of a medical college were selected by systematic random sampling and interviewed. Data analysis done with the using Microsoft excel. Results: Out of 154 mothers, 51.3% of the mothers were in the age group of 25-34 years followed by 47.4% of the mothers in the age group less than 25 years and only 1.3 % of the mothers were more than 35 years of age. Mean age ± SD of the mothers was 25.26 ± 3.73 with the youngest and the oldest mother being 19 and 39 years old respectively. Among the respondents by religion, majority (80.5%) were Hindus followed by 15.6 % Muslims and only 3.9% were Christians. Conclusion: Time of complementary feeding initiation varied according child’s gender, predominant caregiver of the child, mother’s parity and socio economic status of the family, which were found to be statistically significant.

An Evaluation of SGOT among the Patient which Suffered from Thyroid Disorders

Alkaline phosphatase, ALP is found in all tissue of the body.(4) The enzyme responsible for extracellular catabolism of glutathione’s is Gamma glutamyltransferase, GGT]. It is the main thiol intracellular antioxidant agent. The larger function of enzyme is to transport amino acid and peptide into the cell across the cell membrane in the form of gamma glutamyl peptidase. The only iodine containing amine hormones in the vertebrate are Triiodothyronine (T3) and thyroxine (T4). Methods: All samples were taken from hypothyroid, hyperthyroid and euthyroid subjects who fasted for at least 8 hours before the blood collection.Serum separated and analyzed for T3, T4, TSH, CK-NAC, CK-MB, LDH and AST(SGOT) . The sample was processed in standardized manner under set protocol in the Department of Biochemistry. Results: Among the total of 300 subjects of ages 25 -50 years of both sexes were included in the study, 100 were hypothyroid, 100 were hyperthyroid and 100 were euthyroid. Their serum levels of T3, T4 and TSH were estimated and confirmed. Conclusion: The present study might be beneficial in public health and clinical practice, as both thyroid disorders and cardiovascular diseases are important issue of concern to reduce the morbidity and mortality.

Influence of Smokeless Tobacco on Periodontal Health Status in Local Population of North India: A Cross-Sectional Study

Introduction: In addition to smoking, smokeless tobacco hasalso evidently shown its effect on various oral tissues.Smokeless tobacco products have been in existence forthousands of years among populations in South America andSoutheast Asia in varied forms.Methodology: This cross-sectional study investigated theeffect of commonly used smokeless tobacco on periodontalhealth in local population of nearby villages of Air Force StationBakshi Ka Talab, U.P., India, for which 2045 individuals[males=1455 (71%), females=590 (28.9%)] were evaluated.Results: Maximum incidence of smokeless tobaccoconsumption was observed in the age group 21–30 years(39.4%), whereas minimum consumption was observed in theage group 10–20 years (7.5%). The peak smokeless tobaccoconsumption was observed between the ages 21 and 40 years.Recording of oral hygiene measures included in this studyshowed majority of subjects (n=1961) used tooth brushing asthe oral hygiene measure, while some used datoon (n=30;1.5%) for cleaning their teeth and others used their finger(n=54; 2.6%) with or without tooth powder.Conclusion: This study conclude that, PPD were significantlyhigher statistically amongst longer duration (>5 years)smokeless tobacco users as compared to non-tobacco users.

Comparing Refractive Error with Axial Length in the Subjects Having Refractive Error

Introduction: Refractive error has now become the secondmost common cause of blindness across the world. Thereis necessity to explore the various factors having impact onrefractive errors as they will certainly assist in the variousmodes of treatment aspect of the refractive errors. This studywas carried out with the aim of comparing refractive errorwith axial length in the subjects with refractive error.Material and methods: In this study, total of 500 adult caseswere recruited. So total of 1000 eyes were examined upon.This study was carried out, over a total period of 2 years.General examination was carried out in each and every case.Afterwards, local examination was done. Then refractive errorand axial length was measured. The data obtained from thisstudy was analysed statistically.Results: The results of our present study have showed thatthe spherical refractive error has statistically highly significantnegative correlation with axial length, in right eye (r=-0.836,p<0.01) and in left eye (r=-0.859, p<0.01).Conclusion: The observation made from this study says thaton progressing from myopic to hyperopic refractive error, theaxial length of the eye is found to decrease. In the refractiveerror of shortsightedness or myopia, the final image is formedahead of retina

Initial trends of individual donation nucleic acid testing in voluntary & replacement donors from a tertiary care centre in north India

Background & objectives: Individual donation nucleic acid testing (ID-NAT) is considered as sensitive technology to assess blood safety from viral transfusion-transmissible infections (TTIs) in blood donors. The present study was aimed to analyze the results of ID-NAT for three years (2013-2015) with special reference to different types of donors and their age ranges in a tertiary care centre in north India. Methods: The results of ID-NAT for three years were retrospectively analyzed at our centre. A total of 168,433 donations were tested with ID-NAT, of which 10,467 were tested with Procleix® Ultrio® reagents and 157,966 were tested with Procleix®UltrioPlus® reagents, and the results were compared with those of serology to calculate the NAT yield in voluntary, replacement, first-time and repeat donors. Results: A combined NAT yield was observed as one in 1031 out of 167,069 seronegative donations with HBV yield as one in 1465, HCV yield as one in 3885 and HIV-1 as one in 167,069. Yield for co-infection (HCV and HBV) was one in 41,767. A high NAT yield was observed in replacement donors (1 in 498) as compared to voluntary donors (1 in 1320). Interpretation & conclusions: Addition of NAT to serology improved the blood safety in our centre interdicting possibility of 150 TTIs annually. It has also reemphasized the safety of voluntary over replacement donors. The results also highlight the need of proper counselling, notification and referral guidelines of NAT yield donors in our country and other countries which lack them.

A Study of Complementry Feeding Practices amongst Mothers of Children Aged Six Months to Two Years Attending an Immunisation Clinic

Introduction: Infant and young child feeding indicators havebeen developed by the World Health Organization (WHO), toguide and monitor the feeding practices of young children. TheWorld Health Organization (WHO) recommends exclusivebreast feeding (EBF) for the first six months of life, with theaddition of complementary feeds (CF) at six months withcontinued breast feeding until at least the age of two years.Study aimed to find out the complementary feeding practicesamongst mothers of children aged six months to two years.Material and Methods: A cross sectional study ofcomplementary feeding practices amongst mothers of childrenaged six months to two years in an urban setting. Therefore atotal of 154 subjects were taken into the study. The study wasconducted from Jan 2014 – Sep 2015.Result: Among the studied children, 59.7% were males and40.3% were females. Almost more than half of the childrenwere in the age groups of more than 9 months and only 18.2%were in the age group 6 – 8 months.Conclusion: This study suggested that accurate informationand education should be given to mothers and caregiversabout appropriate breast-feeding and complementary feedingpractices to prevent malnutrition and improve the health statusof the children

Learning Preferences of Undergraduate Dental Students: A Longitudinal Assessment Over Four Years

Objective: To compare the learning preferences of 78 undergraduate dental studentsfrom the first to thefourth year of dental education.Methods: The study assessed the learning sensory modality preferences of the first-year students byadministering Fleming’s VARK questionnaire and reassessed the same students in fourth-year, using thesame questionnaire and methodology.Results: A significant increase in the mean visual scores was observed from 2.91±1.81 in the first year to3.63±2.06 in the fourth yearof dental education (p-value 0.036). Also, the mean aural scores significantlyincreased from 4.87±2.22 in the first year to 5.86±2.18 in the fourth year (p-value 0.005). Although the meanread/write scores and the mean kinestheticscoresalso increased over four years, yet these were notstatistically significant. Additionally, amultimodal learning style was observed in 53.84% students of first-year and 51.28%students offourth-year.Conclusions: A significant increase in the mean visual scores and the mean aural scores of students fromthe first to fourth year of dental education demonstrates that learning preferences are dynamic in nature. Fordelivering student-centered education, educators need to be cognizant of this potential shift so that teachingstrategies and resourcesmay bemodified for improved learning and student satisfaction.

Study on Uric Acid as Biomarker for Insulin Resistance in Type 2 Diabetic Mellitus

Serum uric acid (SUA) is an end product of purine metabolism. SUA is excreted mainly through the kidneys. Multiple mechanisms have been reported to show the association of hyperuricemia with glucose intolerance. The association between insulin and renal resistance to absorption of urates has been found out to be the most important among these mechanisms. Methods: This comparative study contains 50 subjects of type 2 diabetes having an age group of 40-65 years were participated in case & 50 healthy subjects as control group. This case control study conducted in the department of department of biochemistry, LPS institute of Cardiology, GSVM medical college, Kanpur. Results: In the case-control study were found 54% male and 46% female in case group & 42% female and 58% female. We suggested that in study group 44% cases were belongs to 61-65 age group followed by other while in control group 42% were belongs to 61-65 age group followed by other age group. Conclusion: This study conclude that there were significant correlation between uric acid and HOMA-IR value. Hyperuricemia is related to risk factors for insulin resistance in type 2 diabetes. The study concluded a significant progressive relationship between increased uric acid level with respect to HOMA-IR levels which is an indices of insulin resistance.