Vertical teaching principles: pregnancy induced hypertension

Background: The methodology of teaching is of three types. “Adhyapana” refers to “act of teaching” or the “teacher reads”.  “Adhyayan” is “self-learning” or the “student reads”. “Sambhasa” or “Tatva vidya” refer to “discussion”. Types of learning are again of three types: informative learning, formative learning and transformative learning. Informative learning produces experts. Formative learning produces professionals. Transformative learning in the context of health education produces leaders with global connection. Millers pyramid of competence evolves the steps in learning as knows, knows how, does and teaches how. The aim of the vertical integrated teaching programme on pregnancy induced hypertension was to enable students to comprehend and teach (sambhasa) pregnancy induced hypertension with firm and reinforced understanding of pathophysiology, biochemical markers, radiological predictors, pharmacotherapy and anesthetic consideration. Neonatal problems specific to pregnancy-induced hypertension were also discussed.Methods: Problem based and peer instruction approach was followed. The study was conducted as a one-day teaching-learning programme for final year students (168) of Saveetha Medical College, Chennai, India. All the basic sciences and their translation into clinical skills were explained pertaining to the problem of hypertension in pregnancy. Plenary discussion of each clinical case of hypertension and convulsion in pregnancy was done in a galaxy of experts from each department.The teaching faculty of the department of biochemistry, pathology, pharmacology, radiology, general medicine, anesthesia and obstetrics and gynecology and neonatal medicine provided a learning module in the web forum of university website for the final year medical undergraduate students. The students were able to comprehend pregnancy-induced hypertension (PIH) from its basics and decide on the relevant clinical implications. A case based discussion was done with the constellation of experts from all disciplines of medicine. This was followed with mind mapping of concepts developed. Pretest and posttest helped the teaching faculty to assess the impact of knowledge generated. Feedback was obtained to improvise the existing teaching method sand develop new teaching tools.Results: The median, the 25th percentile, the 75th percentile and extreme values in pretest and posttest group were plotted using Sigma plot. An improvement in scores was observed.Conclusions: Vertical integration of medical disciplines helps medical students to understand a clinical problem in the light of basic sciences. The modules beginning with the pathophysiology of pregnancy induced hypertension and concluded with anesthetic considerations.  An elaborate module helps to translate an understanding of pharmaco therapeutics of hypertension in pregnancy. A well-trained medical student can help to reduce maternal mortality due to preeclampsia

Sustainable Production of Guava Based Hortipasture System with Different In-Situ Soil and Moisture Conservation in Semi-Arid Region of India

In India, about 60 % of net sown area is rainfed, contributing 40 % of the total food production; it supports 40% of human and 60% of livestock population. Under such situation, incorporation of fruit trees along with animal husbandry in common farming system is advisable to improve income and nutritional security of the farmers. Horti- pasture system is the most ideal strategy to provide food, nutrition and income security to the people living in rainfed areas. System is socially accepted, ecologically feasible and economically viable for this region (Singh, 1996; Sharma, 2004; Kumar and Chaubey, 2008). Guava (Psidium guajava L.), is one of the most common and nutritious and hardy fruits of India, can thrive on all types of soil from alluvial to lateritic with pH value as low as 4.5 and on limestone with a value up to 8.2. It occupies about 1, 15,000-1, 62000 ha area in the country (Shikhamany, 2004). Two new cultivars viz., Lalit (CISH-G-3) and Shweta (CISH-G-4) were taken in this experiment. Stylosanthes hamata (Caribbean stylo) is an important range legume for semiarid region (Chandra et al., 2006). Similarly Cenchrus ciliaris (Buffel grass) is most suitable species for arid and semiarid region with rainfall range from 125-1250 mm (Trivedi, 2010). Establishment of hortipasture system is quite difficult task in rainfed region because of moisture stress. Providing regular irrigation is neither practically possible nor economical in rainfed region. Harvesting of rainwater and in-situ moisture conservation is only viable alternative to artificial irrigation. Shaping the surface in the immediate vicinity of the trees so that runoff collects at the root zone can enhance availability of moisture for long duration (Samra, 2010). Keeping these facts in view an experiment was conducted to sustain the productivity of guava based hortipastoral system with different in-situ soil and moisture conservation measures under rainfed situations

Vertical teaching principles: pregnancy induced hypertension

Background: The methodology of teaching is of three types. and ldquo;Adhyapana and rdquo; refers to and ldquo;act of teaching and rdquo; or the and ldquo;teacher reads and rdquo;. and ldquo;Adhyayan and rdquo; is and ldquo;self-learning and rdquo; or the and ldquo;student reads and rdquo;. and ldquo;Sambhasa and rdquo; or and ldquo;Tatva vidya and rdquo; refer to and ldquo;discussion and rdquo;. Types of learning are again of three types: informative learning, formative learning and transformative learning. Informative learning produces experts. Formative learning produces professionals. Transformative learning in the context of health education produces leaders with global connection. Millers pyramid of competence evolves the steps in learning as knows, knows how, does and teaches how. The aim of the vertical integrated teaching programme on pregnancy induced hypertension was to enable students to comprehend and teach (sambhasa) pregnancy induced hypertension with firm and reinforced understanding of pathophysiology, biochemical markers, radiological predictors, pharmacotherapy and anesthetic consideration. Neonatal problems specific to pregnancy-induced hypertension were also discussed. Methods: Problem based and peer instruction approach was followed. The study was conducted as a one-day teaching-learning programme for final year students (168) of Saveetha Medical College, Chennai, India. All the basic sciences and their translation into clinical skills were explained pertaining to the problem of hypertension in pregnancy. Plenary discussion of each clinical case of hypertension and convulsion in pregnancy was done in a galaxy of experts from each department. The teaching faculty of the department of biochemistry, pathology, pharmacology, radiology, general medicine, anesthesia and obstetrics and gynecology and neonatal medicine provided a learning module in the web forum of university website for the final year medical undergraduate students. The students were able to comprehend pregnancy-induced hypertension (PIH) from its basics and decide on the relevant clinical implications. A case based discussion was done with the constellation of experts from all disciplines of medicine. This was followed with mind mapping of concepts developed. Pretest and posttest helped the teaching faculty to assess the impact of knowledge generated. Feedback was obtained to improvise the existing teaching method sand develop new teaching tools. Results: The median, the 25th percentile, the 75th percentile and extreme values in pretest and posttest group were plotted using Sigma plot. An improvement in scores was observed. Conclusions: Vertical integration of medical disciplines helps medical students to understand a clinical problem in the light of basic sciences. The modules beginning with the pathophysiology of pregnancy induced hypertension and concluded with anesthetic considerations. An elaborate module helps to translate an understanding of pharmaco therapeutics of hypertension in pregnancy. A well-trained medical student can help to reduce maternal mortality due to preeclampsia. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000): 1739-1743

An integrative approach to the facile functional classification of dorsal root ganglion neuronal subclasses

Somatosensory neurons have historically been classified by a variety of approaches, including structural, anatomical, and genetic markers; electrophysiological properties; pharmacological sensitivities; and more recently, transcriptional profile differentiation. These methodologies, used separately, have yielded inconsistent classification schemes. Here, we describe phenotypic differences in response to pharmacological agents as measured by changes in cytosolic calcium concentration for the rapid classification of neurons in vitro; further analysis with genetic markers, whole-cell recordings, and single-cell transcriptomics validated these findings in a functional context. Using this general approach, which we refer to as tripartite constellation analysis (TCA), we focused on large-diameter dorsal-root ganglion (L-DRG) neurons with myelinated axons. Divergent responses to the K-channel antagonist, κM-conopeptide RIIIJ (RIIIJ), reliably identified six discrete functional cell classes. In two neuronal subclasses (L1 and L2), block with RIIIJ led to an increase in [Ca]i. Simultaneous electrophysiology and calcium imaging showed that the RIIIJ-elicited increase in [Ca]i corresponded to different patterns of action potentials (APs), a train of APs in L1 neurons, and sporadic firing in L2 neurons. Genetically labeled mice established that L1 neurons are proprioceptors. The single-cell transcriptomes of L1 and L2 neurons showed that L2 neurons are Aδ–low-threshold mechanoreceptors. RIIIJ effects were replicated by application of the Kv1.1 selective antagonist, Dendrotoxin-K, in several L-DRG subclasses (L1, L2, L3, and L5), suggesting the presence of functional Kv1.1/Kv1.2 heteromeric channels. Using this approach on other neuronal subclasses should ultimately accelerate the comprehensive classification and characterization of individual somatosensory neuronal subclasses within a mixed population

Setup error analysis in helical tomotherapy based image-guided radiation therapy treatments

The adequacy of setup margins for various sites in patients treated with helical tomotherapy was investigated. A total of 102 patients were investigated. The breakdown of the patients were as follows: Twenty-five patients each in brain, head and neck (H and N), and pelvis, while 12 patients in lung and 15 in craniospinal irradiation (CSI). Patients were immobilized on the institutional protocol. Altogether 2686 megavoltage computed tomography images were analyzed with 672, 747, 622, 333, and 312 fractions, respectively, from brain, H and N, pelvis, lung, and CSI. Overall systematic and random errors were calculated in three translational and three rotational directions. Setup margins were evaluated using van Herk formula. The calculated margins were compared with the margins in the clinical use for various directions and sites. We found that the clinical isotropic margin of 3 mm was adequate for brain patients. However, in the longitudinal direction it was found to be out of margin by 0.7 mm. In H and N, the calculated margins were well within the isotropic margin of 5 mm which is in clinical use. In pelvis, the calculated margin was within the limits, 8.3 mm versus 10 mm only in longitudinal direction, however, in vertical and lateral directions the calculated margins were out of clinical margins 11 mm versus 10 mm, and 8.7 mm versus 7.0, mm respectively. In lung, all the calculated margins were well within the margins used clinically. In CSI, the variation was found in the middle spine in the longitudinal direction. The clinical margins used in our hospital are adequate enough for sites H and N, lung, and brain, however, for CSI and pelvis the margins were found to be out of clinical margins

Conotoxin κM-RIIIJ, a tool targeting asymmetric heteromeric Kv1 channels

The vast complexity of native heteromeric K+ channels is largely unexplored. Defining the composition and subunit arrangement of individual subunits in native heteromeric K+ channels and establishing their physiological roles is experimentally challenging. Here we systematically explored this zone of ignorance in molecular neuroscience. Venom components, such as peptide toxins, appear to have evolved to modulate physiologically relevant targets by discriminating among closely related native ion channel complexes. We provide proof-of-principle for this assertion by demonstrating that κM-conotoxin RIIIJ (κM-RIIIJ) from Conus radiatus precisely targets asymmetric Kv channels composed of three Kv1.2 subunits and one Kv1.1 or Kv1.6 subunit with 100-fold higher apparent affinity compared with homomeric Kv1.2 channels. Our study shows that dorsal root ganglion (DRG) neurons contain at least two major functional Kv1.2 channel complexes: a heteromer, for which κM-RIIIJ has high affinity, and a putative Kv1.2 homomer, toward which κM-RIIIJ is less potent. This conclusion was reached by (i) covalent linkage of members of the mammalian Shaker-related Kv1 family to Kv1.2 and systematic assessment of the potency of κM-RIIIJ block of heteromeric K+ channel-mediated currents in heterologous expression systems; (ii) molecular dynamics simulations of asymmetric Kv1 channels providing insights into the molecular basis of κM-RIIIJ selectivity and potency toward its targets; and (iii) evaluation of calcium responses of a defined population of DRG neurons to κM-RIIIJ. Our study demonstrates that bioactive molecules present in venoms provide essential pharmacological tools that systematically target specific heteromeric Kv channel complexes that operate in native tissues