Mannequin-based simulation as an educational tool for learning injection techniques: medical students’ view points

Background: Mannequin-based training devices are simulation adjuncts that mimic reality in healthcare settings for acquiring basic procedural skills, without compromising patient safety. The current study aims to explore students’ perceptions of mannequin-based simulation as an educational tool and perceived changes in self-confidence by using a mixed-method research.Methods: This questionnaire‑based study was conducted in 2nd year MBBS students. Pre-validated questionnaires measured the quantitative and qualitative aspects of simulation-training in-terms of their relevance as teaching–learning tool, perceived benefits of sessions, and their importance for future use. The study further attempted to note any perceived change in students’ confidence, measured before and after sessions. Chi-square and Fischer-exact test were computed for quantitative responses. Wilcoxon signed-rank test (two-tailed) was used to analyse students’ confidence rating before and after simulation. Categorical data were represented as frequencies and proportions.Results: Overall, the sessions were well received by students. Over 90% of students agreed that simulation is a safe, enjoyable and feasible modality for acquiring basic clinical skills. Majority opined that sessions helped them integrate basic-life sciences and clinical concepts, improved attention span and urged inclusion in undergraduate curriculum. Students perceived significant improvements (p<0.001) in confidence post-training. Free-text responses were positive with students highlighting the need for simulation sessions and suggestions for improvement.Conclusions: Most students consider mannequin-based learning as an essential tool to acquire procedural skills. By promoting active student engagement and impactful learning, simulations justify inclusion in medical curriculum for better patient safety

Assessment on awareness of rational prescribing practices among medical interns in a tertiary care hospital: a questionnaire based study

Background: Awareness about rational use of Medicines is required to improve the quality of health care system. Attitude towards rational drug use is also an utmost importance as they constitute the future generation doctors.Methods: A set of 13 questionnaire is given to the interns through an online link to their e-mail which contains informed consent and questionnaires. Respondents has to select the best suitable option and after which the data will be compiled and statistically analyzed.Results: Age of the study participants range from 22-26yrs. Half of them have finished major postings. Almost 96.1 % of them were aware of the term essential drugs. Only 25% of them said that they have NLEMI at work place, 75% of them were aware of the term Rational use of Medicines. Only 32% of them were aware of the term P drugs. 44% of them were aware of STEP criteria for selection of drug and 47% of them were aware of the updated prescribing format. 8% knew the difference between old and new prescription format, 25% of them always prescribe. Almost 82% of them narrate regarding the disease and drug therapy, 31% of them prescribe only generic name.Conclusions: Educational intervention like CME and practical hands on training in Rational use of Medicines would help them in better understanding of the subject and its clinical implications thereby decreasing the prescribing errors

Induced variability for yield and its attributing traits in cluster bean [Cyamopsis tetragonoloba (L. ) Taub] through gamma irradiation

Gamma ray is an effective mutagen which creates useful variability for crop like cluster bean where the natural variation is very meagre and creation of variability by conventional methods is cumbersome. In the present study, cluster bean cv. Pusa Navbahar was treated with different level of gamma rays from 50 Gy to 600 Gy with 50Gy interval and obtained M2 population was subjected to variability estimation for yield and its attributing traits in augmented block design. The variance between the control and the mutants was found to be significant for plant height, number of pods per cluster, number of pods per plant, pod length, pod width, pulp to seed ratio. For these traits, PCV ranged from 14.28 per cent (pod width) to 31.99 per cent (pulp to seed ratio) whereas, GCV ranged from 10.10 per cent (pod width) to 24.16 per cent (pulp to seed ratio). The heritability in broad sense ranged from 50 per cent (pod width) to 79.99 per cent (Plant height). Genetic advance expressed as percentage over mean ranged from 2.06 per cent (pod width) to 222.44 per cent (plant height). The traits like plant height, pod length, pod width, pulp to seed ratio showed sufficient variability due to induced mutation. All these traits showed medium to high heritability and high genetic advance hence selection for these traits will be effective

TRIM2, a novel member of the antiviral family, limits New World arenavirus entry

Tripartite motif (TRIM) proteins belong to a large family with many roles in host biology, including restricting virus infection. Here, we found that TRIM2, which has been implicated in cases of Charcot-Marie-Tooth disease (CMTD) in humans, acts by blocking hemorrhagic fever New World arenavirus (NWA) entry into cells. We show that Trim2-knockout mice, as well as primary fibroblasts from a CMTD patient with mutations in TRIM2, are more highly infected by the NWAs Junin and Tacaribe virus than wild-type mice or cells are. Using mice with different Trim2 gene deletions and TRIM2 mutant constructs, we demonstrate that its antiviral activity is uniquely independent of the RING domain encoding ubiquitin ligase activity. Finally, we show that one member of the TRIM2 interactome, signal regulatory protein alpha (SIRPA), a known inhibitor of phagocytosis, also restricts NWA infection and conversely that TRIM2 limits phagocytosis of apoptotic cells. In addition to demonstrating a novel antiviral mechanism for TRIM proteins, these studies suggest that the NWA entry and phagocytosis pathways overlap.Peer reviewe

The Singapore Asymptomatic Narrow Angles Laser Iridotomy Study (ANA-LIS): 5 year results of a Randomized Controlled Trial

PURPOSE: To examine the efficacy of laser peripheral iridotomy (LPI) in subjects diagnosed as primary angle closure suspects (PACS) DESIGN: Prospective, randomized controlled trial PARTICIPANTS: This multi-center, randomized controlled trial (NCT00347178, Clinical trials.gov) enrolled 480 subjects over the age of 50 years from glaucoma clinics in Singapore with bilateral asymptomatic PACS (defined as having ≥2 quadrants of appositional angle closure on gonioscopy). METHODS: Each subject underwent prophylactic LPI in one randomly selected eye, while the fellow eye served as control. Subjects were followed up yearly for 5 years. MAIN OUTCOME MEASURES: The primary outcome measure was development of primary angle closure (PAC, defined as presence of peripheral anterior synechiae, and/or intraocular pressure>21 mmHg or acute angle closure [AAC]) or PACG over 5 years. RESULTS: Of the 480 randomized subjects, the majority were Chinese (92.7%) and female (75.8%) with mean age of 62.8±6.9 years. LPI-treated eyes reached endpoint less frequently after five years (24, 5.0%, incidence rate [IR]=11.65 per 1000 eye-years) compared to control eyes (45, 9.4%, IR=21.84 per 1000 eye-years, p=0.001). The adjusted hazards ratio (HR) for progression to PAC was 0.55 (95%CI: 0.37-0.83, p=0.004) in LPI-treated eyes compared to control eyes. Older subjects (per year, HR=1.06, 95%CI: 1.03-1.10, p<0.001) and eyes with higher baseline IOP (per mm Hg, HR=1.35, 95%CI: 1.22-1.50, p<0.0001) were more likely to reach an endpoint. The number needed to treat in order to prevent an endpoint was 22 (95%CI: 12.8-57.5). CONCLUSIONS: In subjects with bilateral asymptomatic PACS, eyes that underwent prophylactic LPI had significantly fewer endpoints compared to control eyes over 5 years. However, the overall incidence of PAC or PACG was low

Comparison of central corneal thickness and anterior chamber depth measurements using three imaging technologies in normal eyes and after phakic intraocular lens implantation

Contains fulltext : 81835.pdf (Publisher’s version ) (Open Access)BACKGROUND: The repeatability and interchangeability of imaging devices measuring central corneal thickness (CCT) and anterior chamber depth (ACD) are important in the assessment of patients considering refractive surgery. The purpose of this study was to investigate the agreement of CCT and ACD measurements using three imaging technologies in healthy eyes and in eyes after phakic intraocular lens implantation (pIOL). METHODS: In this comparative study, CCT and ACD were measured using anterior segment optical coherence tomography (AS-OCT), Orbscan II, and Pentacam in 33 healthy volunteers (66 eyes) and 22 patients (42 eyes) after pIOL implantation. Intraobserver repeatability was evaluated for all three devices in the healthy volunteer group. RESULTS: Pairwise comparison of CCT measurements showed significant differences between all devices (P < 0.001), except for the AS-OCT and Orbscan II in the healthy volunteer group (P = 0.422) and the Orbscan II and Pentacam in the pIOL group (P = 0.214). ACD measurements demonstrated significant differences between all pairwise comparisons in both groups (P < or = 0.001). Intraobserver reliability was high for CCT and ACD measurements in the healthy volunteer group, with coefficients of variation ranging from 0.6% to 1.2% and 0.4% to 0.5% respectively. CONCLUSIONS: CCT and ACD measurements using AS-OCT, Orbscan II, and Pentacam demonstrated high intraobserver reliability. However, these devices should not be used interchangeably for measurements of CCT and ACD in healthy subject and patients after pIOL implantation

Phase diagram of the two-dimensional Hubbard-Holstein model

The electron\u2013electron and electron\u2013phonon interactions play an important role in correlated materials, being key features for spin, charge and pair correlations. Thus, here we investigate their effects in strongly correlated systems by performing unbiased quantum Monte Carlo simulations in the square lattice Hubbard-Holstein model at half-filling. We study the competition and interplay between antiferromagnetism (AFM) and charge-density wave (CDW), establishing its very rich phase diagram. In the region between AFM and CDW phases, we have found an enhancement of superconducting pairing correlations, favouring (nonlocal) s-wave pairs. Our study sheds light over past inconsistencies in the literature, in particular the emergence of CDW in the pure Holstein model case

Serological responses to prednisolone treatment in leprosy reactions: study of TNF-α, antibodies to phenolic glycolipid-1, lipoarabinomanan, ceramide and S100-B.

BACKGROUND: Corticosteroids have been extensively used in the treatment of immunological reactions and neuritis in leprosy. The present study evaluates the serological response to steroid treatment in leprosy reactions and neuritis. METHODS: Seven serological markers [TNF-α, antibodies to Phenolic glycolipid-1 (PGL-1 IgM and IgG), Lipoarabinomannan (LAM IgG1 and IgG3), C2-Ceramide and S100 B] were analyzed longitudinally in 72 leprosy patients before, during and after the reaction. At the onset of reaction these patients received a standard course of prednisolone. The levels of the above markers were measured by Enzyme linked immunosorbent assay (ELISA) and compared with the individuals own value in the month prior to the reaction and presented as percentage increase. RESULTS: One month before the reaction individuals showed a varying increase in the level of different markers such as TNF-α (53%) and antibodies to Ceramide (53%), followed by to PGL-1 (51%), S100B (50%) and LAM (26%). The increase was significantly associated with clinical finding of nerve pain, tenderness and new nerve function impairment. After one month prednisolone therapy, there was a fall in the levels [TNF-α (60%), C2-Ceramide (54%), S100B (67%), PGL-1(47%) and LAM (52%)] with each marker responding differently to steroid. CONCLUSION: Reactions in leprosy are inflammatory processes wherein a rise in set of serological markers can be detected a month before the clinical onset of reaction, some of which remain elevated during their action and steroid treatment induces a variable fall in the levels, and this forms the basis for a variable individual response to steroid therapy