Undergraduate teaching in COVID-19 pandemic: an experience at tertiary care centre

Background: COVID-19 outbreak has taught us to opt for technologies, which have not been used before. There is lot of information available on the internet for learning, but undergraduate students of medicine need continuous guidance. The best platform would be live online teaching which includes student centred learning and observing appropriate COVID-19 social distancing. Aims and objectives of the study was to highlight various positive and negative impacts of COVID-19 on medical education.Methods: The students included in the study are from second MBBS with total number of 200. Time table was planned and everyday two live lectures across their subjects of study were taken. The classes were carried out using the Cisco Webex software. The students were able to ask questions and cleared doubts during and at the end of each class. The feedback of the session was collected by structured format and observations recorded.Results: In the present study the advantages of online classes based on student observations were: learning at ease, flexible environment, no delay in classes, and no peer distraction. In the present study the disadvantages were: eyes are getting strained, network issues, concentrate for long time, disturbances at home and no practical knowledge. In the present study, improvements and suggestions offered were to provide recorded videos or power point presentation, case based discussions, assignments and revision classes to be increased.Conclusions: The present study had several limitations. The study was conducted during the first phase of the COVID-19 pandemic at a Government Institute where most students belong to middle class. Despite these limitations, we believe the study provides relevant insights into the challenges facing online medical education in a time of healthcare crisis

Giant congenital melanocytic nevus scalp: report of a rare case

Giant congenital melanocytic nevus (garment nevus) is a kind of congenital malformation of neural crest cells with size greater than 20 cm. Malignant melanoma may develop in 2-31% of these lesions. The objective of this paper is to present a unique case of giant nevus which is rare

Prospective study of histopathological patterns of ovarian tumours in a tertiary care centre

Background:Ovarian tumours account for 3% of all cancers amongst women, being the second most common cancer of the female genital tract. The ovarian tumours are highly heterogenous with a wide range of histological patterns. Aim of current study was to study the histological patterns and the age incidence of the ovarian tumours in our institute.Methods:The present study is a prospective study conducted in the department of pathology, Andhra Medical College, from August 2011 to July 2013.Results:We received a total of 267 specimens of ovarian tumours during this period, out of which, 263 were primary and 4 were secondary tumours. Benign tumours were 209 (78.3%), borderline were 10 (3.7%) and malignant were 48 (18%) in numbers. Overall surface epithelial tumours constituted the majority of tumours accounting for 214 (80.2%) cases, followed by germ cell tumours 38 (14.2%) and sexcord stromal tumours 11 (4.1%). The single most common tumour diagnosed was serous cystadenoma. The most common malignant tumour was serous cystadenocarcinoma. The age groups affected ranged from 11-70 years. The peak age incidences for different histological types were as follows: surface epithelial tumours: 21-50 years, germ cell tumours: 21-30 years, sexcord stromal tumours: 51-60years. Benign tumours were more common in 21-40 years of age, borderline in 31-50 years and malignant tumours in 41-50 years age group.Conclusion:The results from our study were comparable with those reported in literature; however malignant serous and mucinous tumours showed a lower peak age incidence in our study. Krukenberg tumours also occurred in younger age group in our study.

Malignant melanoma of breast: a case report

Malignant melanoma rarely affects the breast. Malignant melanoma of breast is divided into two categories: primary and metastatic lesions. Primary melanoma involves the skin and less commonly the glandular parenchyma of the breast. Differentiating them is very important in deciding on treatment strategies. This case report aims to increase awareness of unusual neoplasms of the breast which requires a different surgical and adjuvant therapeutic approach

Evaluation of the effectiveness of seminar as an educational tool among the medical post graduate students

Background: The departments of medical colleges have a greater responsibility in making the study methods of their subject innovative, interesting and participatory for the post graduate students. One such method adopted is organizing seminars for the post graduate students. The post graduate education depends on self-learning. Knowledge acquisition through seminars forms an essential part of their training programme.Methods: This study assesses the role of seminar as teaching-learning tool by recording the perception of post graduates on seminars through a questionnaire based survey.Results: The scores for most of the items of a twenty point questionnaire were above three indicating the learning from seminar is satisfactory. Seminar methods of teaching-learning, in contrast to the traditional didactic class room lecture method, is more effective way of  learning, which is relevant to self-development and is also interactive. This method provokes discussions and debates which help post graduate students to voice their opinion and clear their doubts.  Conclusions: Many of the post graduate students feel that this technique of seminar programme is useful amidst some suggestions to improve quality. Thus the post graduate seminar method is a teaching-learning method that covers the three major domains of teaching i.e., cognitive, affective and psychomotor skills and is thus effective and well -accepted among the post graduate students.

Role of urine sediment cytology in the diagnosis of renal disorders in comparison with biochemical and histopathological findings

Background:The functional reserve of the kidney being large, serum biochemical parameters do not show abnormality until late. The need to recognize minimal damage in the kidneys is hence valuable. Urine sediment examination is cost effective, time saving and is called “liquid renal biopsy”. The present study was aimed to evaluate the role of urine sediment examination in predicting the severity of renal damage and compare the results with serum biochemical parameters, 24 hour urine protein values and renal biopsy findings.  Methods:A total of 149 patients presenting with symptoms pertaining to renal disease were included in the study. Clinical information and serum biochemical parameters were obtained. Urine examination was done and renal biopsy performed in all the cases. 2 scoring systems were adopted to grade the urine sediment findings and renal biopsy grading devised by A. Z. Gyory et al. was used to grade the renal injury. 24 hour urine protein was estimated by Esbach’s method. Urine sediment scores, serum biochemical parameters, 24 hour urine protein values were compared with the grades of renal injury on renal biopsies and statistical significance calculated.Results:32.8% of patients with renal disease were in the age group of 31-40 years. Nephrotic syndrome was the most common clinical presentation (33.5%) followed by nephritic syndrome (21.4%). The most common histopathological diagnosis was post infectious glomerulonephritis (n = 26) followed by acute interstitial nephritis (n = 17). 14 cases of lupus nephritis were diagnosed all of which were confirmed by “full house” pattern of immunofluorescence. Both the urine sediment scores had high specificity and positive predictive values in predicting the severity of renal injury. 24 hour urine protein had high positive predictive value in predicting the severity of renal injury. Serum biochemical parameters were insignificant in predicting the severity of renal injury.Conclusion: Urine sediment examination can be used as an effective diagnostic test for predicting the severity of renal injury. The decision of further investigations and follow-up can be certainly decided by taking urine microscopy findings and 24 hour urine protein values into consideration.