Correction to: Metachronous Sarcomas-a Case Report.

[This corrects the article DOI: 10.1007/s13193-019-01005-5.].

Comparison of Objective Structured Practical Examination (OSPE) Versus Conventional Pathology Practical Examination Methods Among the Second-Year Medical Students-a Cross-sectional Study.

INTRODUCTION: The medical education in India is moving towards competency-based medical education (CBME) with many cognitive and psychomotor skills needed to be taught and assessed in the various subjects of the undergraduate medical curriculum. In the Pathology subject, psychomotor skills such as haemoglobin estimation, blood grouping, urine examination, liver function test/cerebrospinal fluid interpretation, histopathology and haematology slide interpretation are taught and assessed for many years. Skill assessment by the conventional method, which is followed since many years, is subjective in nature and lack of scope for direct observation of the performance of skills. Objective structured practical examination (OSPE) is one of the methods to minimize the variations in subjectivity, thus enhancing the objectivity. Due to a technicality and labour intensity, it is implemented only in a few medical colleges and universities across India. Because of CBME curriculum on the roll, the assessment of practical skills in medical education needs to be shifted from conventional subjective methods to more objective OSPE methods. MATERIAL AND METHODS: After institutional ethical clearance, the second-year medical students appearing for practical in Pathology were selected for the study. Practical skills of the students were assessed by both the conventional way and OSPE after obtaining the written consent. Among 104 students, 89 students were assessed by both methods. Adequate instructions about the pattern of the examination were given in both assessment methods. For the OSPE group, specific instructions about the role of observer, response stations and method of scoring were given. Practical performance of haemoglobin estimation and blood grouping by slide method was assessed, and scores were compared. Student and faculty perception regarding OSPE was assessed by a prevalidated questionnaire. RESULTS: In the conventional group, the mean score of 6.91 ± 1.08 was obtained, while in OSPE, it was 8.43 ± 1.41. In comparing both, a p value of > 0.001 was obtained, which is found to be significant. Student's perceptions appeared to favour the OSPE format rather than the traditional examination. CONCLUSION: This study showed a significant difference in scores obtained by OSPE in comparison with conventional practical examination. Thus, this information suggests that OSPE format was perceived better by the students, and resulted in a higher average score. Hence, the use of OSPE as a formative assessment tool will help in modifying teaching-learning strategies so that it is beneficial to students and teachers.

Neuroendocrine Carcinoma of Duodenum-an Uncommon Tumour at an Unusual Site.

Neuroendocrine carcinoma rarely occurs in the duodenum, and most cases of neuroendocrine carcinoma in the duodenum show rapid progression of the disease. Such cases have poor prognosis even with radical surgery with or without chemotherapy with low 5-year survival rate. We present a case of a 52-year-old man who presented with abdominal pain of 1-month duration and one episode of vomiting. Upper gastrointestinal endoscopy revealed polypoidal lesions in the first and second part of the duodenum. Whipple's procedure was performed. Diagnosis of poorly differentiated neuroendocrine carcinoma was made with extension to pancreas with peripancreatic lymph node metastases. The patient expired on post operative day 17 following cardiac arrest.

Identification and Characterization of Lipopeptides from Bacillus subtilis B1 Against Sapstain Fungus of Rubberwood Through MALDI-TOF-MS and RT-PCR.

Bacillus subtilis is a potent biocontrol agent producing a wide array of antifungal lipopeptides for the inhibition of fungal growth. B. subtilis B1 isolated from market-available compost provided an efficient control of rubberwood sapstain fungus, Lasiodiplodia theobromae. The current study is aimed to identify and characterize the lipopeptides responsible for the biocontrol of rubberwood sapstain fungus by Bacillus subtilis B1. The bacterial whole-cell surface extract from the dual culture of B. subtilis B1 and sapstain fungus (L. theobromae) was analysed using MALDI-TOF-MS. The protonated as well as sodium, potassium adducts of homologues of iturin C, surfactin, bacillomycin D and fengycin A and B were identified and expression of the lipopeptide biosynthetic genes could be confirmed through RT-PCR. This is the first report of mycobacillin and trimethylsilyl derivative of bacilysin during antagonism through MALDI-TOF-MS. MALDI-TOF-MS with RT-PCR offered easy platforms to characterize the antifungal lipopeptides. The identification of antifungal lipopeptides can lead to the formulation of prospective biocontrol by-products which have wide-scale utility.

Screening of bacterial biocontrols against sapstain fungus (Lasiodiplodia theobromae Pat.) of rubberwood (Hevea brasiliensis Muell.Arg.).

Diverse bacterial biocontrol agents from various sources of aerobic composts against the sapstain fungus Lasiodiplodia theobromae in rubberwood (Hevea brasiliensis) were isolated, screened and identified by various morphological, biochemical and molecular techniques. The inhibitory effect of seventeen bacterial isolates was examined and seven exhibited inhibition towards the sapstain fungus. Among the seven antagonists, six were conclusively identified as Bacillus subtilis and one as Paenibacillus polymyxa using 16S rRNA-encoding gene sequencing. This is the first report on the occurrence of P. polymyxa, a potent biofertilizer and antagonist in vermicompost. HiCrome Bacillus agar was identified as an effective medium for differentiation of B. subtilis from other Bacillus species. The present work demonstrates the efficacy of the antagonistic property of B. subtilis strains against rubberwood sapstain fungus. Culture-based antagonistic inhibition displayed by B. subtilis can be extended to cater to the biocontrol requirements of wood-based industries against the stain fungus. The study showed the utility of an integrated approach, employing morphological, biochemical and molecular tools for conclusive identification of several bacterial isolates present in aerobic composts from diverse sources.

A Rare Case of an Epidermoid Cyst in the Parotid Gland - which was Diagnosed by Fine Needle Aspiration Cytology.

Cystic lesions are common in the head and neck. The most common are the cutaneous cysts, which are referred to as epidermal cysts. These cysts present as nodular and fluctuant subcutaneous lesions and they are seen most commonly in the acne - prone areas like the head, neck and the back. They arise following a localized inflammation of the hair follicle and occasionally after the implantation of the epithelium, following a trauma or surgery. The presence of benign cystic lesions in the salivary glands is rare.We are presenting a rare case of a 55-year-old male who presented with a soft swelling on the left side of the face. A diagnosis of an epidermoid cyst was given on cytology. A superficial parotidectomy was performed and the histopathology confirmed the above diagnosis.

Serum vitamin d levels in Indian patients with multiple sclerosis.

Low serum vitamin D level has an increased association with risk of multiple sclerosis (MS).There has been no published data on the levels of this vitamin in Indian population with MS. Hence we decided to undertake this study to document if there is evidence of vitamin D deficiency in patients with MS in our population. 26 patients with diagnosis of MS by modified Mc Donald's criteria were enrolled in this study. Serum vitamin D (1,25 hydroxy) levels were measured by electro-chemiluminescence in our biochemistry lab. An age-matched control group of 202 patients who did not have a diagnosis of MS were included. In our study group 76.9 % had vitamin D level less than 20 ng/ml compared to 65.5 % of control group (p value of 0.019). Our study revealed a trend towards low vitamin D values in Indian MS patients.

An INSIGHT in to "KATIGRAHA" (LOW BACK ACHE).

Low back pain is becoming a major health problem now a days. This may be due to adopting faulty posture and living habits. A glance through Ayurvedic classic reveal many terms used for describing the condition. This article aims to understand these terms in a better way and to make a proper diagnosis for better management.This article aims to understand these terms in a better way and to make a proper diagnosis for better management.