Refining the Journal Club Presentations of Postgraduate Students in Seven Clinical Departments for Better Evidence‑based Practice

Background: A gap between best practice and actual clinical care exists and this can be overcome by evidence‑based practice (EBP), which is essential to improve the clinical decision making. A strategy to reduce deficits in care provision is to train the postgraduate students in the practice of EBP in the journal clubs as evidence from medical colleges in India reveals that current format of journal club presentations is unsatisfactory. Aim: The aim of the present study was to refine the journal club presentations of postgraduate students of clinical departments and to study the effectiveness of EBP training in them for better EBP. Subjects and Methods: This study was conducted in S. Nijalingappa Medical College, Bagalkot, Karnataka, India, and it was a pre‑ and post‑trial. This study was a pre‑ and post‑trial done during the journal club presentations of postgraduate students from clinical departments. Postgraduate students’ understanding of concepts about EBP was assessed using Fresno test questionnaire in traditional journal club presentation. A hands‑on session incorporating steps of EBP was imparted to them. Soon after the session, each student was assessed. In the next journal club presentation, 1 week later, the students were assessed again with the same questionnaire by the same faculty. Scores of the postgraduate students, before and after intervention (immediate and 1 week later), were compared. Data were analyzed by paired t‑test using SPSS. Results: An increase in mean posttest scores was seen immediately and also 1 week later as compared to the pretest scores. The scores also increased significantly, when each step of EBP was considered. Conclusions: Incorporating teaching of EBP in journal club presentations improved the competencies of postgraduate students in clinical decision making.Keywords: Evidence‑based practice, Journal club, Postgraduate trainin

The Benefits of Progressive Occipital Condylectomy in Enhancing the Far Lateral Approach to the Foramen Magnum.

BACKGROUND: The portion of the occipital condyle that is safe to remove remains controversial in the transcondylar approach. We aimed to correlate the gain in exposure with incremental removal of the occipital condyle to determine if there is a point where further drilling yields diminishing gains. METHODS: Virtual reality rendering of the skull was generated from 25 subjects with no posterior fossa pathology. A suboccipital far lateral craniotomy was done in virtual reality space, stopping at the posterior edge of the occipital condyle. Angular measurements of surgical corridor were taken at this point and after removal of 25% and 50% of the condyle. Two surgical targets were used: at the anterior midline of the foramen magnum and the vertebrobasilar junction. RESULTS: Progressive removal of the occipital condyle increased exposure to both targets in a linear fashion. For the midline of the foramen magnum, the working angle increased from 12° to 18° for quarter condylectomy and then to 25° for half condylectomy. The corridor to the vertebrobasilar junction was much tighter, and the angle increased from 5.5° to 9° for quarter condylectomy and then to 12° for half condylectomy. The gain in exposure for the low target was greater than for the high target (P \u3c 0.001). CONCLUSIONS: Progressive removal of the occipital condyle yielded a linear increase in exposure without an ideal point beyond which the drilling was futile. However, the impact of condylectomy was greater for our low target compared with our high target

Effect of Short-Term Pranayama and Meditation on Cardiovascular Functions in Healthy Individuals

Context: Asana, pranayama, and meditation are three main techniques of yoga practiced in India over thousands of years to attain functional harmony between the body and mind. Recent studies on long-term yogic practices have shown improvements in cardiovascular functions. Aim: The present study was conducted to ascertain if a short-term practice of pranayama and meditation had improvements in cardiovascular functions in healthy individuals with respect to age, gender, and body mass index (BMI). Settings and Design: This interventional study was conducted in the Department of physiology of S.N. Medical College, Bagalkot. Patients and Methods: Fifty healthy subjects (24 males and 26 females) of 20−60 years age group, fulfilling the inclusion and exclusion criteria underwent two hours daily yoga program for 15 days taught by a certified yoga teacher. Pre and post yoga cardiovascular functions were assessed by recording pulse rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure. Statistical analysis used: The parameters were analyzed by Student′s t test. Results: There was significant reduction in resting pulse rate, systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure after practicing pranayama and meditation for 15 days. The response was similar in both the genders, both the age groups, 40 yrs and both the groups with BMI, 25 kg/m2 . Conclusion: This study showed beneficial effects of short term (15 days) regular pranayama and meditation practice on cardiovascular functions irrespective of age, gender, and BMI in normal healthy individuals

Thyroid Status in Relation to Age and Gender - A Cross Sectional Study

Background: Thyroid disorders have become much more common in the present days and so are its resultant complications or sequelae. There are marked variations in thyroid function with age and sex, evident in all of the in vitro hormone and protein measurements. Objective: To correlate the thyroid status with age and gender. Methods: 500 subjects of all age group and both genders from the general population of Bagalkot, Karnataka were included in the study. Subjects suffering from thyroid disorders were excluded. Non-Fasting venous samples were collected from all the subjects, serum T3, T4, and TSH levels were estimated by microplate immunoenzymometric assay. Statistical analysis was done by ANOVA and unpaired ‘t’ test. Results: It was observed that T3 and T4 levels declined but TSH levels raised, as the age advanced. T3 and T4 levels were lower and TSH levels higher in female subjects as compared to male subjects, in the age group of 21 – 40 years. Conclusion: The variability in the thyroid status has to be borne in mind during evaluation and treatment of thyroid disorders

Microencapsulation of celecoxib using various methods and polymers

Microencapsulation is a process in which active substances are coated by extremely small capsules. It is a new technology that has been used in the cosmetics industry as well as in the pharmaceutical, agrochemical and food industries, being used in flavours, acids, oils, vitamins, microorganisms, among others. This paper provides an UpToDate review of different microencapsulation methods and polymers used specifically for Celecoxib drug. As Celecoxib is poorly soluble in water, there are several methods used to improve solubility and bioavailability using various polymers. The different microencapsulation methods along with different polymers were studied and given a comprehensive review. There are several NSAIDs which are used for pain management and Celecoxib is a non-steroidal anti-inflammatory drug used in the treatment of osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation, and menstrual symptoms. There are many techniques available that can be used to fabricate microcapsules based on desired characteristics, and applications of the final microcapsule formulation. For Celecoxib microencapsulation, Spray drying techniques are widely used method for the research studies. some of the advantages of spray-drying include its ability to be fully automated and continuous