Association of Umbilical Cord Coiling and Medical Disorders of Pregnancy: a Cross-Sectional Study.

Introduction: The coiling of the umbilical vessels develops by about 28 days post-conception and is present in about 95% of foetuses by around nine weeks of conception. Umbilical coiling (UC) is associated with many maternal and fetal outcomes. The present study attempts to assess any associations between medical disorders of pregnancy with umbilical cord coiling. Methodology: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Gandhi Medical College δ Sultania Zanana Hospital, Bhopal, India, from January to December 2020. A total of 300 obstetric mothers were included in the study. Coiling of the umbilical cord numbers and pattern and umbilical coiling index was assessed at the time of delivery. Medical disorders such as diabetes mellitus, hypertension and thyroid disorders during pregnancy were evaluated at the time of delivery. Data was entered and analysed with Epi info software. Results:Gestational diabetes mellitus was seen in hyper-coiled and normocoiled, but not also in hypocoiled UC. Hypothyroidism with GDM was seen only in hypocoiled UC. A significant association was seen with selected endocrinal medical problems with umbilical cord coiling (P value <0.05). The most common blood pressure-related disorder identified in the present study is eclampsia (66.66%). Gestational hypertension was seen only in hypocoiled UC coiling. Conclusion:The most common endocrine disorder associated with umbilical cord coiling was gestational diabetes in hyper coiled and normocoiled UC. Hypocoiling and normocoiling have been found in medical disorders of pregnancy. Multicentric studies are required to identify the relationship between endocrine and blood pressure-related disorders and umbilical coiling.

Perception of the Educational Environment and Its Impact on the Academic Performance of Medical School Students: a Cross-Sectional Study.

Objective: To assess the perception of medical school students on their learning environment and to evaluate the association between their academic performance and perception. Material and methods: This was a cross-sectional study conducted in one public and one private medical school in Delhi and Tamil Nadu states of India, respectively, among 415 medical students using systematic random sampling. Dundee Ready Educational Environment Measure (DREEM) questionnaire was used to assess the perception of the educational environment. Academic performance was analysed using the average percentage of marks scored from the recently passed final university examination scores. Results:The mean (SD) age of study participants was 21.9 (1.4) years. The mean (SD) overall score for public and private institutes was 134.5 (20.23) and 98.4 (25.14), respectively. There was no significant difference in the mean overall score between the academic year; however, there was a significant difference in students' perception of learning (SPoL), with higher scores being found among the fourth year and interns (p-value <0.001). Conclusions:The public institute had significantly higher total and subtotal scores when compared to private institutions. Evaluation of the ongoing educational program using the DREEM tool helps to identify the students' perception of the academic environment.

A study on the preference of teaching methods among medical undergraduate students in a tertiary care teaching hospital, India.

BACKGROUND: In medical education, the learning-teaching method is an active process in which both students and teachers have to work mutually to enlighten the knowledge. Currently, in India, there is an increase in the enrollment of students in medical fields and thus medical educators face the challenge of teaching larger classes in a short period. Furthermore, it is observed that there is a lack of consensus about the best teaching and learning methods for medical students. This study aims to assess the preference of teaching methods and identify the reason for absenteeism among medical undergraduate students in a tertiary care teaching hospital. MATERIALS AND METHODS: A cross-sectional study was conducted among 246 medical undergraduate students in a tertiary care teaching hospital from August 2019 to October 2019. A pretested, validated self-administered questionnaire was used to assess the preference of teaching methods. The data were analyzed using SPSS-IBM software 23. RESULTS: The majority of the students belonged to 20-21 years of age group. Most of the students preferred practical demonstration (81.3%) as the preferred method of teaching and computer with a liquid crystal display projector as ideal media for teaching (63.8%). Boring/monotonous teaching class was found (73.5%) to be an important cause for absenteeism among medical undergraduate students. CONCLUSION: The results indicate that the medical student's preference is changing from passive learning to active learning. We conclude by linking these emerging perceptions with suggestions to help drive excellence in medical education.

Social stigma among tuberculosis patients attending DOTS centers in Delhi.

BACKGROUND: Every year >9 million people suffer from tuberculosis (TB) and India accounts for >25% of global TB burden. Tuberculosis patients experience both psychological and social suffering. Amongst the problems met by tuberculosis patients, social stigma has been increasingly recognized. This study was done to assess social stigma and associated factors among the tuberculosis patients attending Directly Observed Treatment Short-course (DOTS) centers in South East Delhi. MATERIAL AND METHODS: It was a cross-sectional study carried out among tuberculosis patients availing treatment from DOTS centers of South East Delhi. Out of 48 DOTS centers in South East Delhi, 6 centers were selected on the basis of population proportion to size. A total of 270 TB patients were interviewed using a semi-structured, pretested questionnaire consisting of stigma-based questions. Fisher exact and Chi-square test applied. RESULTS: The mean age of patients was 31.5 years (SD ± 11.5) with age ranging from 18 to 77 years. Males were higher (57.4%) compared to females (42.6%). 123 (45.5%) perceived stigma with family/friends and 92/158 (58.2%) perceived stigma at workplace. Young patients (<30 years), males faced more stigma at workplace and lower socioeconomic class faced higher stigma with family and friends (P < 0.05). CONCLUSION: There is still higher stigmatization faced by patients with TB at family/friends and at workplace. Motivation by friends/family and support at workplace has been crucial in achieving successful treatment outcomes.

A study on knowledge and practice of Ergonomics among the Software Engineers in a private firm, Chennai, Tamil Nadu.

BACKGROUND AND AIMS: Due to multiple reasons like prolonged sitting and postural demands, software engineers are prone to develop musculoskeletal problems, which can be easily alleviated by practicing proper Ergonomic posture in their workstation. The main objective of the study was to assess the knowledge of Ergonomics Principles and Workplace Practice among the software engineers working in a private firm. METHODOLOGY: This was a cross-sectional study conducted among 403 software engineers working in a private firm, Chennai. RESULTS: Among the 403 study participants, 85.6% had musculoskeletal problem in any area of focus. Only 9% had adequate ergonomic knowledge and only fewer among them practice it adequately. CONCLUSION: The study revealed higher prevalence of musculoskeletal problem, lower prevalence of knowledge about Ergonomic principles and much lower prevalence of appropriate practice of Ergonomic principles. This can be alleviated by a simple primary care like ergonomic education and practising.

Personality traits as a predictor of emotional intelligence among medical students.

INTRODUCTION: Emotional intelligence (EI) is the ability to understand and manage our own feelings and of others. It has emerged as one of the vital elements of success and interpersonal relations in everyday life. There are individual differences of EI depending on characteristics and behaviors of an individual, which determines their personality. AIMS AND OBJECTIVES: The present study assesses the EI and personality traits of medical students and determines the relationship of EI with personality traits of the medical students. MATERIALS AND METHODS: This was a cross-sectional study and was conducted among students of a government medical college, located in New Delhi. A total of 210 participants were included in the study. After obtaining written informed consent from all participants, a questionnaire consisting of demographic information, Ten-Item Personality Inventory and Schutte EI Scale, was administered. The means and proportions were calculated. Chi-square test and Pearson's correlation test were used to test significance. P < 0.05 was considered statistically significant. RESULTS: The mean (standard deviation) age of the study participants was 21.54 (±1.98) years. The majority (65.7%) of the students were male. 51% of the students had moderate EI, and high EI was seen in 49% of the students. A positive and significant relationship between personality traits and EI was found in the study. CONCLUSION: Personality traits and EI are related to one another and could influence student academic achievement. Since EI influences academic performance so personality trait assessment and empathic perceptions exploration can facilitate to aid the academic performance of the students.

Effect of educational intervention on the knowledge of rabies among medical school students of Chennai.

BACKGROUND: Although rabies is highly fatal, with timely and correct postexposure prophylaxis (PEP) of animal bite victims, it could be prevented. Medical school students should be trained about the appropriate rabies management during their formative years so that they put the right practice later on. The study was conducted to assess the knowledge about rabies epidemiology and prophylaxis among medical students and to find the effect of an educational intervention. MATERIALS AND METHODS: This was a quasi-experimental study conducted with 156 third academic year medical school students at a tertiary care teaching hospital. The study participants were given health education intervention. A study tool assessed the knowledge of study participants on domains such as epidemiology of rabies, pre-exposure prophylaxis (PrEP) and PEP, and national program guidelines of rabies prevention. The study tool was administered before and after the intervention. The impact of educational intervention was measured with scores. Wilcoxon signed-rank test was applied to test the difference. RESULTS: The overall total mean pretest total score was 14.9 (±3.7) and posttest score was 22.7 (±3.23) for a maximum score of 29. The mean pretest scores for epidemiology, PrEP and PEP and national program components were 6.09, 7.95, and 0.85 respectively. Likewise, the mean posttest scores were 8.09, 13.26, and 1.35 respectively. There were a statistically significant improvement in the scores after health education intervention. CONCLUSIONS: After educational intervention, there were statistically significant improvement in the scores of all the three domains. PrEP and PEP and national program domain of rabies need to be emphasized during formative years.

Medical research: Perception and barriers to its practice among medical school students of Chennai.

BACKGROUND: Knowledge of medical students about research has been little explored. Although there has been a practice of medical research among undergraduate level, the practice is not universal and there have been potential barriers and difficulties in carrying out the research. The present study was done to find the perception and attitude toward medical research and to assess the practices and potential barriers in carrying out medical research. METHODOLOGY: This cross-sectional study was conducted among 344 medical school students of a medical college in Chennai, Tamil Nadu, in 2018. Systematic random sampling was used. The study tool was self-administered questionnaire including questions on knowledge, barrier, and 5-point Likert scale for assessing attitude. Adequate knowledge (>70% correct answers) and positive attitude (>25 score) were considered. RESULTS: Among the 344 study participants, only 127 (36.9%) of students had adequate knowledge and 68 (19.8%) had positive attitude toward medical research. Regarding practice of research, only 34.3% had conducted a research and only 17.4% had published in journals. Difficulty in choosing topic, difficulty in collecting data, and allocation of time amidst academic activities were considered as a barrier by 41.6%, 40.7%, and 45.9%, respectively. Association of adequate knowledge and practice was statistically significant for age (P = 0.000), gender (P = 0.000), and academic year (P = 0.000). CONCLUSION: Adequate knowledge and positive attitude were lacking in majority of students. Barriers could be addressed by support programs and sensitization toward research.

Health research methodology workshop: Evaluation with the Kirkpatrick model.

Background: Workshops on research methodology impart skills of research among medical students. Both qualitative and quantitative evaluation of an academic programme is essential to enhance the effectiveness and quality improvement. We assessed the gain in learning and effect of a workshop on research methodology among medical students. Methods: We did a quasi-experimental, single-group study at a tertiary care hospital and research institute in southern India. It included 33 students enrolled in various residency positions of the institute. The Kirkpatrick 4-level model was used to assess the effectiveness of the workshop on research methodology. Paired t-test was used to compare pre- and postworkshop scores. Results: Twenty-five students rated the academic sessions as excellent. The score before the workshop ranged from 0 to 17 with mean (SD) 9.27 (4.2). The post-workshop score had a minimum to maximum score of 10-26 with mean (SD) of 16.18 (3.7) (p<0.005). The effect size d cohen (confidence interval [CI]) was 1.743 (0.942-2.545). The mean (SD) of absolute and relative gain was 10.8 (3.8) and 1.41 (0.07), respectively. 66.7% medical students showed a 30% rise in their post-workshop scores, the cut-off for effectiveness of the workshop. Conclusion: The evaluation of a workshop on research methodology provided insights into the outcomes and modifications required for their future improvement.

Integrated counseling and HIV testing centers of Delhi: An evaluation.

BACKGROUND: HIV counseling and testing services are a key entry point in prevention of HIV infection, treatment, and care of people with HIV. Evaluation of counseling, testing, and referral services help to increase the effectiveness, efficiency, and quality of services delivered by providers by improving any deficiencies in availability, accessibility, and acceptability of testing and counseling services. The objective of this study was to evaluate the integrated counseling and testing centers (ICTC) in New Delhi. MATERIALS AND METHODS: The evaluation study was conducted among ICTCs during 2014-2015. Twenty ICTCs of New Delhi were selected on the basis of population proportion to the size of clients catered. The study tool was pretested structured tool for evaluating HIV voluntary counseling and testing (VCT). The evaluation tool consists of an assessment of components including the availability of infrastructure, laboratory services, referral services, and staff availability. Counseling sessions were also observed for assessing content and quality. Means and proportions were calculated. RESULTS: Twelve (60%) ICTCs had dedicated counseling rooms ensuring privacy for the clients. Waiting space was reported to be adequate in 16 (80%) ICTCs. Space within counseling room was observed to be adequate in 8 (40%) ICTCs. Counselors of both sexes were present in 12 (60%) ICTCs. Both external and internal quality assurance was observed in all ICTCs. Standard operating procedures were followed in 15 (75%) ICTCs. On observation of the counseling sessions, it was found that 67.4% of male counselors and 67.2% of female counselors addressed all the issues of content of counseling. CONCLUSION: ICTCs lack waiting area and adequate space in counseling room and required staff personnel. Records maintenance and laboratory quality control maintained by ICTCs were found to be adequate. The counseling rooms lack privacy that may compromise the confidentiality of clients. Few components of counseling need improvement.

Attitude toward learning of community medicine: A cross-sectional study among medical school students.

BACKGROUND: Community medicine strives to protect and promote the health and well-being of the community through primary health care approach. However the preference of community medicine as career among medical school students and curriculum of community medicine is pivotal. AIM: The study intended to find the attitude towards learning of community medicine and also to assess the preference of post graduation specialty among medical school students. MATERIALS AND METHODS: A cross sectional study conducted at a teaching hospital located in Tamil Nadu, South India. The study questionnaire was administered to a total of 500 study participants and the data collected were analyzed using SPSS IBM version 21.0. RESULTS: Almost 97% were of the opinion that community medicine subject is mandatory. Eighty three percent were interested in learning the principles. Only 21.8% students wanted to pursue post graduation in community medicine. Lack of attraction in terms of scientific technical interest, workplace conditions, and research potential has been reported for being not interested. CONCLUSION: Majority enjoyed to learn principles of community medicine at undergraduate curriculum but only few preferred to opt community medicine as post graduate specialty. Therefore there is a room to influence the medical students positively towards learning community medicine in curriculum.

Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study.

INTRODUCTION: Multi Drug Resistant Tuberculosis (MDR TB) has emerged as a significant public health problem in India. The prolonged treatment duration in MDR TB is a challenge in achieving treatment completion and poses a threat to TB control in the country. Home based care is an approach accepted by patients because it helps in ameliorating their understanding of TB, improving the compliance and reducing stigma in the community. AIM: To assess the outcome of Home-Based Care (HC) versus No Home-Based Care (NHC) on the treatment of MDR TB patients registered at two chest clinics in Eastern Delhi. MATERIALS AND METHODS: A quasi-experimental study was done among diagnosed MDR TB patients receiving Category IV regimen under Revised National Tuberculosis Control Programme (RNTCP) from two government chest clinics in Eastern Delhi during May 2014 to May 2016. In the control arm, 50 MDR TB patients at one of the chest clinics were offered the standard Category IV regimen under RNTCP; while in the intervention arm, 50 MDR TB patients at the second chest clinic were provided home based care (counselling, support for completion of treatment, rehabilitation, and nutritional support) along with the standard treatment. The primary outcome assessed was outcome of treatment, while secondary outcomes included stigma faced due to the disease, and impact of disease on family and community life. RESULTS: The primary outcome data was available for 32 (64%) participants in the intervention arm, and 38 (76%) participants in control arm. The treatment was significantly more successful in the intervention arm (p<0.03). The data on secondary outcomes was available for all participants. Stigma due to disease was significantly lower in the intervention arm (p<0.01); also rejection faced by participants from family and community due to disease was significantly lower among the HC group (p<0.05). CONCLUSION: Home-based care in MDR TB treatment holds potential in improving treatment outcomes of patient.