"Test-enhanced" focused self-directed learning after the teaching modules in biochemistry.

Focused self-directed learning is very much essential at present in medical education to catch-up with the increasing information load. Cognitive psychology laboratory studies show that repeated testing of information produces superior retention relative to repeated study. The overall goal of this intervention was to evaluate the effectiveness of "Test enhanced learning" in the form of "Open book examination" as a formative assessment in Biochemistry when compared to "Self-study." Three exercises were carried out after the regular teaching sessions on different topics in biochemistry for the first year MBBS students. A multiple choice questions based pretest was conducted after the regular lecture classes on a topic but before the revision exercise. The students were subjected "Open book examination" with short answer questions for a period of 1 hour. A posttest was done with the same set of MCQs after the revision exercises. The gain score of "Open book examination" was compared with that of "Self study." Feedback from the students was taken. The isolated results from each of the three exercises conducted and their combined results supported the hypothesis that "Test enhanced learning" in the form of open book examination is a superior form of learning process than self-study for assimilation of knowledge. Most of the students opined that the "Open book examination" enhanced their self directed focused learning process. The students felt that "Open book examination" is more beneficial than "Self study" in reinforcing the learning concepts after regular didactic lectures. © 2018 International Union of Biochemistry and Molecular Biology, 46(5):472-477, 2018.

Association Between Adiponectin and Insulin Resistance in Diabetic Urolithiasis.

OBJECTIVES: The prevalence of urolithiasis is increasing worldwide. Diabetes mellitus (DM) is characterized by insulin resistance, which increases the risk of kidney stone formation. Adiponectin is an insulin-sensitizing and anti-inflammatory cytokine, which is known to improve glucose tolerance and insulin resistance in humans. The association of insulin and adiponectin with kidney stones is not clear. Hence, the present study aim to assess the serum levels of adiponectin and insulin resistance in DM patients with urolithiasis in comparison to those without. METHODS: This study involved two groups, group A consisted of 30 patients with DM and urolithiasis, and group B consisted of 30 patients with DM but without urolithiasis (control group). Biochemical parameters studied were serum adiponectin, insulin, glucose, urea, creatinine, and 24 hours urinary calcium and phosphate. RESULTS: The serum adiponectin level was significantly increased in the diabetic urolithiasis cases (group A) compared to the control group (group B). The levels of 24 hours urine calcium and phosphorus were also significantly increased in group A. There was no significant difference in serum insulin and homeostasis model assessment of insulin resistance between the two groups. A negative correlation was seen between serum adiponectin and insulin among the cases (r = -0.368 and p = 0.045). CONCLUSIONS: We found that serum adiponectin levels are increased in patients with DM and urolithiasis.

Is urolithiasis associated with increased levels of high sensitivity C-reactive protein and interleukin-6 in diabetic patients?

BACKGROUND: The prevalence and incidence of urolithiasis is increasing worldwide. Type 2 diabetes mellitus is well known to be associated with insulin resistance which increases the risk of urolithiasis by altering the composition of urine. Both urolithiasis and diabetes mellitus are associated with inflammation. The aim of the study was to assess the serum levels of inflammatory markers i.e. high sensitivity C-reactive protein (hsCRP) and Interleukin-6 (IL-6) in diabetes mellitus patients with urolithiasis in comparison to those without urolithiasis. MATERIALS AND METHODS: The study involved two groups. Group A consisted of diabetic mellitus patients with urolithiasis (n=30) and Group B consisted of diabetic mellitus patients without urolithiasis (n=30). Blood samples were obtained and analysed for HbA1C, lipid profile, calcium, phosphate and uric acid, and inflammatory markers (C-reactive protein and Interleukin-6) were also measured. RESULTS: We found a significant increase in CRP and IL-6 levels in diabetic urolithiasis cases as compared to diabetes mellitus cases without urolithiasis. However, no significant difference was observed in calcium, phosphorus and uric acid in diabetic patients with and without urolithiasis. We also found that total cholesterol, triglycerides, LDL-cholesterol and VLDL-cholesterol levels were significantly increased, and HDL-cholesterol was significantly decreased in diabetic urolithiasis cases. IL-6 was significantly correlated with total cholesterol in diabetic urolithiasis cases. CONCLUSION: The data from the present study shows that lipid profile is altered, and Interleukin-6 and C-reactive protein levels are significantly increased in patients with diabetes mellitus and urolithiasis when compared to diabetes mellitus alone.

Association between prolactin and thyroid hormones with severity of psychopathology and suicide risk in drug free male schizophrenia.

BACKGROUND: Hormonal deregulation is associated with suicidal risk in various psychiatric disorders. Thyroid hormones and prolactin play a role in the pathophysiology of schizophrenia. The present study aimed to analyze thyroid hormones and prolactin levels in patients with schizophrenia, and to explore its association with disease severity and suicide risk. METHODS: Thirty-eight cases and 38 controls were included in the study. Serum thyroid hormones and prolactin were estimated in all the subjects. Disease severity was assessed using the Positive and Negative Syndrome Scale and suicidal ideations were assessed using the Columbia Suicide Severity Rating Scale. RESULTS: Serum prolactin (p=0.004) and free T4 (p=0.029) were significantly elevated in the schizophrenia group as compared to controls. Serum prolactin was significantly associated with higher negative symptom scores (r=0.418, p=0.008), but not positive symptoms or general psychopathology of schizophrenia. Thyroid hormones were not associated with disease severity scores. Suicidal ideas were more common in schizophrenia patients with higher free T4 (p=0.011). CONCLUSION: Prolactin and free T4 were increased in patients with schizophrenia as compared to controls. Suicidal ideation was associated with increased free T4, but not prolactin levels.