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Introduction: Patients with diabetes mellitus monitor their blood glucose at home with monitors that require a drop of blood or use a continuous glucose monitoring device that implants a small needle in the body. However, both cause discomfort to the patients which may inhibit them for regular blood glucose checks. Photoplethysmogram (PPG) sensing technology is an approach for non-invasive blood glucose measurement and PPG sensors can be used to predict hypoglycaemic episodes. InChcek is a PPG-based non-invasive glucose monitor. However, its accuracy has not been checked yet. Hence, this study aimed to evaluate the accuracy of InCheck, a non-invasive glucose monitor for the estimation of blood glucose. Methods: In a tertiary care hospital, patients who came for blood glucose estimation were tested for blood glucose non-invasively on the InCheck device and then by the laboratory method (glucose oxidase-peroxidase). These two readings were compared. We used International Organization for Standardization (ISO) 15197:2013 (95% of values should be within ± 15 mg/dL of reference reading if reference glucose <100 mg/dL or within ± 15% of reference reading if reference glucose ≥100 mg/dL and 99% of the values should be within zones A and B in consensus error grid), and Surveillance Error Grid for analyzing the accuracy. Results: A total of 1223 samples were analyzed. There was a significant difference between the reference method glucose level (135 [Q1-Q3: 97 - 179] mg/dL) and monitor-measured glucose level (188.33 [Q1-Q3: 167.33-209.33] mg/dL) (P < 0.0001). A total of 18.5% of readings were following ISO 15197:2013 criteria and 67.25% of coordinates were within zone A and zone B of the consensus error grid. In the surveillance error grid analysis, about 29.4% of values were in the no-risk zone, 51.8% in slight risk, 18.6% in moderate risk, and 0.2% were in the severe risk zone. Conclusion: The accuracy of the InCheck device for the estimation of blood glucose by PPG signal is not following the recommended guidelines. Hence, further research is necessary for programming or redesigning the hardware and software for a better result from this optical sensor-based non-invasive home glucose monitor.
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Background Artificial intelligence (AI) has the potential to be integrated into medical education. Among AI-based technology, large language models (LLMs) such as ChatGPT, Google Bard, Microsoft Bing, and Perplexity have emerged as powerful tools with capabilities in natural language processing. With this background, this study investigates the knowledge, attitude, and practice of undergraduate medical students regarding the utilization of LLMs in medical education in a medical college in Jharkhand, India. Methods A cross-sectional online survey was sent to 370 undergraduate medical students on Google Forms. The questionnaire comprised the following three domains: knowledge, attitude, and practice, each containing six questions. Cronbach's alphas for knowledge, attitude, and practice domains were 0.703, 0.707, and 0.809, respectively. Intraclass correlation coefficients for knowledge, attitude, and practice domains were 0.82, 0.87, and 0.78, respectively. The average scores in the three domains were compared using ANOVA. Results A total of 172 students participated in the study (response rate: 46.49%). The majority of the students (45.93%) rarely used the LLMs for their teaching-learning purposes (chi-square (3) = 41.44, p < 0.0001). The overall score of knowledge (3.21±0.55), attitude (3.47±0.54), and practice (3.26±0.61) were statistically significantly different (ANOVA F (2, 513) = 10.2, p < 0.0001), with the highest score in attitude and lowest in knowledge. Conclusion While there is a generally positive attitude toward the incorporation of LLMs in medical education, concerns about overreliance and potential inaccuracies are evident. LLMs offer the potential to enhance learning resources and provide accessible education, but their integration requires further planning. Further studies are required to explore the long-term impact of LLMs in diverse educational contexts.
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BACKGROUND: Reusable suction-cup electrodes are used for recording a 12-lead electrocardiogram (ECG) in resource-limited settings. These electrodes may easily detach if those are attached on a hirsute chest. Additionally, the suction pressure may cause erythema and pain. AIM: The aim of this study was to develop a low-cost strap for holding the suction-cup-based precordial electrodes and to test its applicability to the recording of ECG. MATERIALS AND METHODS: A scrap rubber tube was cut in size so that it can cover all the precordial electrode positions. Slit openings (electrodes can be inserted through these opening) were made on this rubber strap. A cloth and a hook-and-loop fastener were used to make an adjustable fastener. ECG was recorded first on 16 non-hairy males with electrodes placed on the chest with the strap and then with electrodes attached by suction. After that, ECG was recorded on 16 males with hirsute chest first with the electrodes placed with the help of the strap and then with suction (without strap) on the shaved chest. RESULTS: The outcome of this study is a low-cost ECG chest strap for a hirsute chest. Both the negative and positive QRS voltages in six precordial leads recorded with electrodes placed with the strap were similar to that of suction-attached electrodes in both non-hairy and hirsute chest. CONCLUSION: Developed rubber chest strap can be made with minimal cost and expertise in any resource-limited settings. This would help in recording the ECG of a patient with a hirsute chest. This prototype strap has scope for further improvement.
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BACKGROUND: Along with stand-alone glucose monitors, smartphone-dependent glucose meters (SDGM) are available for self-monitoring of blood glucose (SMBG). These display-less devices, connected to a smartphone, measure glucose and display report on a smartphone screen, which can be easily shared with doctors. AIM: The aim of this study was to check the accuracy of the available SDGMs in relation to the laboratory reference method. MATERIALS AND METHODS: Two available SDGMs: BeatO™ and GlucoMe™ were tested. A total of 104 venous blood samples were tested for glucose in SDGMs and by the reference method. The accuracy of the report was checked by the International Standards Organization (ISO), American Diabetes Association (ADA), and Clinical Laboratory Improvement Amendments (CLIA) criteria. Clarke error grid analysis (CEGA) was carried out to find the suitability of SDGM in clinical usage. RESULTS: Mean plasma glucose (n = 104) level from laboratory report was 106.48 ± 44.58 mg/dL, that from BeatO™ was 105.78 ± 52.6, and GlucoMe™ was 99.72 ± 51.22. The accuracy was lower than that recommended by ISO 2013 (29.8% and 30.77% error in BeatO™ and GlucoMe™, respectively), ADA (63.46% and 74% error in BeatO™ and GlucoMe™, respectively), and CLIA (42.31% and 46.15% error in BeatO™ and GlucoMe™, respectively) criteria. According to CEGA, BeatO™ and GlucoMe™ can guide correct treatment in diabetes mellitus patients for 74% and 71% of measurement, respectively. CONCLUSION: The accuracy of both the SDGMs was lower than that suggested by ISO, ADA, and CLIA criteria. The result of this study would help patients and doctors in informed choice for the procurement of glucose monitors.
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INTRODUCTION: Students' engagement during the collection of attendance (SEdCA) is a method where students write the answer to a question related to the topic of preceding 1-h lecture. Then, attendance is recorded by the teacher from the answer sheets. This method was introduced primarily to overcome difficulty in recording attendance from a class of high attendance. Its potential formative assessment capability has not yet been ascertained. With this background, the aim of this study was to evaluate the effect of the application of SEdCA as a method of formative assessment on the academic performance of first-year medical students. METHODS: This interventional, uncontrolled, before and after study was conducted on 93 first-year medical students. Part completion test (PCT) scores in anatomy before the application of SEdCA was considered as the pre-intervention academic performance. Then, 1-h lectures were designed according to SEdCA for a period of 3 months. The next PCT scores were taken as post-intervention performance and compared with the pre-intervention performance using paired t-test with α = 0.05. RESULTS: Ninety-three (female=38, male=55) first-year medical students with a mean age of 17.65±0.88 years participated in the study. There was a significant increase in theory (23.74±5.67 versus 26.40±5.17, t=3.31, P<0.001), practical (21.43±6.60 versus 24.08±5.16, t=6.95, P<0.001), and total (45.17±11 versus 50.47±9.17, t=8, P<0.001) scores in the post-intervention PCT. CONCLUSION: SEdCA may be applied to enhance the academic competency of first-year medical students. However, its impact should be evaluated further in multiple subjects in students of different years of study in more institutes for a generalized result.
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BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a condition characterized by the infiltration of fat in the liver cells. High levels of fat in the liver associated with increased risk of diseases like diabetes, high blood pressure and kidney disease, high cholesterol, metabolic syndrome. AIM AND OBJECTIVE: To determine the association between NAFLD and carotid intima media thickness (CIMT) among nondiabetic individuals. MATERIALS AND METHODS: A total of 90 in-patients and outpatients (45 NAFL subjects and 45 patients with the normal liver as controls) with NAFL on abdomen ultrasound scan from Bangalore Baptist Hospital were included in our study. All the participants were subjected to a doppler study for carotid intima thickness and a blood sample (4 ml) was collected from all the subjects. RESULTS: In this study, there is an elevated level of BMI, weight, dyslipidemia in NAFLD compared with controls. The present study suggests that cardiovascular risk factors such as increased carotid intima-media thickness occur more frequently among NAFLD patients compared to healthy individuals. CONCLUSION: We can conclude that NAFL has a significant association with higher cardiovascular risk in terms of carotid intima-media thickness, dyslipidemia, and hypoalphalipidemia. Lifestyle changes include weight loss, dietary changes, reduction of sedentary habits and physical exercise are recommended in the NAFL disease subjects with higher BMI and weight.
