Identifying learning techniques among high achievers

Background: In every college, it is noticed that in spite of being exposed to the same teaching modalities and adopting seemingly similar strategies, some students perform much better than their peers.  This can be evaluated in the form of better academic performance in the internal assessments they undertake.  This project is an endeavor to identify the learning techniques among high achievers which they employ to outperform others. We can also suggest the same to the medium and low achievers so that they can improve their academic performance. This study was conducted to identify different learning techniques adopted by high achievers and suggesting the same to medium and low achievers.Methods: After obtaining clearance from the institutional ethics committee, the high achievers were identified by selecting the upper third of the students in the ascending order of marks obtained in the consecutive three internal assessments in three consecutive batches. The identity of the students was not revealed.  They were then administered an open ended questionnaire which addressed relevant issues. The most common and feasible techniques will be suggested to the medium and low achievers.Results: The respondents’ (n=101) replies were analyzed by calculating the percentages of responses, and assessing based on that, which were the most frequently adapted techniques by these high achieversConclusions: High-achievers have a diligent study pattern; they not only study regularly, but also involve in group discussions and approach their teachers when in doubt. Additionally, they refer to other sources of information like the internet, demonstrating a proactive attitude towards studies

Kinetic theory of electromagnetic ion waves in relativistic plasmas

A kinetic theory for electromagnetic ion waves in a cold relativistic plasma is derived. The kinetic equation for the broadband electromagnetic ion waves is coupled to the slow density response via an acoustic equation driven by ponderomotive force like term linear in the electromagnetic field amplitude. The modulational instability growth rate is derived for an arbitrary spectrum of waves. The monochromatic and random phase cases are studied.Comment: 7 pages, 4 figures, to appear in Physics of Plasma

A cross-sectional observational study on knowledge, attitude and practices about indiscriminate use of antibiotics and antibiotic resistance among medical doctors at Sapthagiri Hospital, Bangalore

Background: WHO defines Antimicrobial resistance (AMR) as “the ability of a microorganism to stop an antimicrobial from working against it”. The Global burden includes increased morbidity, prolonged illness and a higher mortality rate, along with economic burden. The cause can be tracked down to irrational usage of antibiotics and lack of awareness of rational prescribing practices.Methodology: A cross-sectional questionnaire-based observational study was carried out using a standard pre-validated questionnaire, which was administered to all the medical doctors present in their respective departments during the study period, exploring their knowledge regarding rational antibiotic usage, their attitudes and awareness towards AMR. Informed consent from the participants was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics.Results: Majority of doctors (91.3%) have a good knowledge and agree that indiscriminate use of antibiotics leads to antimicrobial resistance. 96.12% of doctors identify it as a global issue but only 85.5% consider it a problem in their hospital. Doctors (78%) have a positive attitude and do not prefer to prescribe an antibiotic for minor illnesses, but only 40% think it might contribute to antimicrobial resistance.Conclusion: Our study has demonstrated that doctors have a good knowledge about the emerging problem of antimicrobial resistance, however a minor percentage of doctors fail to acknowledge this at the level of their own hospital. Regular updates on the local antimicrobial resistance rates & antibiotic stewardship might help to control the global issue of AMR

Audit of prescriptions from the department of general medicine based on the WHO core prescribing indicators at Sapthagiri hospital, Bangalore

Background: As medical students start their clinical training, more effort goes in the direction of proper diagnosis and appropriate methods of treatment, leading to improper training in prescription writing causing prescription errors. Physicians should also be encouraged to prescribe unbranded generic medicines which are available at a cheaper price with a comparable bioavailability of drugs and not have a misconception of being less efficacious.Methods: A cross-sectional observational study was carried out over a period of 2 months (September to October 2018). Around 256 prescriptions were randomly collected from general medicine out-patient department. Informed consent was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics and compared with the derived standard values for WHO prescribing indicators.Results: The analyzed data showed an average of 2.23±1.03 drugs per prescription. 23% of the prescriptions had at least one drug prescribed by generic name, 25% of prescriptions contained an antibiotic and 31% of prescriptions had an injection. The percentage of drugs prescribed from NLEM (National list of Essential Medicines) was only 57% as compared to the recommended 100%. Additional only 22.4% of the total number of FDCs prescribed were from NLEM.Conclusions: The average number of drugs per prescription was slightly high, indicating polypharmacy. Brand name prescribing dominates as doctors are still reluctant to use generic names being doubtful of the efficacy. Regular prescription audit with reporting might help to bring awareness among doctors to follow the recommended guidelines and minimize prescription errors

Selective serotonin reuptake inhibitors and the risk of bleeding

Background: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed agents for various conditions in general psychiatry. There is a strong consensus that blockade of serotonin reuptake affects primary hemostasis, namely platelet activity, thus resulting in a bleeding tendency. Considering that SSRIs are commonly prescribed, this study was conducted to assess if they were associated with an increased risk of bleeding.Methods: This was a prospective, open-label study of 30 patients attending the Psychiatry out-patient department, Dr. B. R. Ambedkar Medical College, Bangalore who satisfied DSM-IV criteria for a primary diagnosis of depression, treated with SSRIs. Bleeding time, clotting time, prothrombin time, partial thromboplastin time and platelet count were assessed at baseline and at the end of 6 weeks of treatment or occurrence of bleeding symptom.Results: The patients aged between 18-55 years of whom 21 were females, were treated with an SSRI (fluoxetine 12, escitalopram 12 and sertraline 6 patients). Six patients had overt symptoms of bleeding (upper gastrointestinal bleeding (hematemesis) 4; epistaxis 2 and petechiae 2) of whom one patient gave a history of both hematemesis and petechiae and another of hematemesis and epistaxis. The average day after treatment beginning, on which patients reported with bleeding was 30.33 (26-40 days). There was a significant increase in the bleeding time (p=0.028) and clotting time (p=0.042), implying derangement in platelet aggregation. There was no significant change in the other parameters.Conclusion: Treatment with SSRIs increases the risk of bleeding. However, large, randomized controlled trials are required to re-affirm these findings

Effect of steroid on platelet count of dengue patients admitted at Sapthagiri Institute of Medical Sciences and Research Centre: a retrospective study

Background: New treatment strategies are attempted to treat the fatal complications of the dengue infection, as significant numbers of adult and children are affected resulting in considerable economic impact. Corticosteroids in various regimens have been used in the last 2 decades empirically on the basis of immunomodulation or treat the vascular leakage that occurs in severe dengue.Methods: A descriptive study was conducted among 60 patients who were dengue positive and received treatment from the Department of Medicine at SIMSRC during the period of June-August 2018. The study group (30 patient) was given treatment with intravenous dexamethasone 8 mg initially, followed by 4 mg TID for 3 days. The control group (30 patient) received only IV fluids and antipyretics. The rise in the mean platelet counts over three days was analyzed in both groups were analyzed.Results: The results of this study revealed that after 10-12 hours of initiating steroids in the study group, a higher and early rise of platelet count was achieved.  There was gradual improvement and increase in platelets in 3 days’ duration in all 30 of the patients. The mean platelet count (the primary outcome) in the study group was significant compared with the control group.Conclusions: At present, realistic approaches for the early intervention and proper treatment protocol are required to be developed to prevent high mortality and morbidity due to dengue. The drawback of this study was, it was not a double-blind placebo-controlled trial and there were less number of patients

A New Sensor Based Communication for Environmental Monitoring

This paper presents the development of a new sensor based communication for environmental monitoring at far off locations. In this proposed system the parameters of sensors are sent to any device having internet by using wireless LAN based on IEEE 802.11b/g standards. The parameters are also sent to mobile phones using GSM. This system includes embedded systems, sensor networks, coordination and management processes and services to capture physical data and to act on the physical environment, all integrated under a intelligent decision system. The system eliminates large amount of solutions, provides the data where network coverage exists

A randomized, open-labelled study of the sedative, analgesic and anxiolytic effect of dexmedetomidine and tramadol in postoperative patients

Background: In the post-operative period, it has always been an important consideration for clinicians, to keep the patient comfortable, calm and pain free. So there is a constant need for an ideal sedative for postoperative patients. Alpha 2 adrenoreceptor agonists such as dexmedetomidine could provide an answer to this problem because they have several relevant physiological properties like sedation, anxiolysis, analgesia and arousability. This prospective, randomized trial was conducted to compare the safety and efficacy of dexmedetomidine and tramadol in the management of postoperative pain.Methods: In the present study 60 patients operated under general anaesthesia with a pain score of 1-3 were randomly allocated into two groups to receive either dexmedetomidine (group D) or tramadol (group T). In both groups, pain score, sedation score, heart rate, blood pressure, SPO2, respiratory rate were monitored for every 5 min for first 30 min, every 10 min for next 1hr, every 15 min for next 1 h, every 30 min for the next 1 h, every 1 h for 3 h and 6th hourly till 24 h. The need for rescue analgesic was also noted. The data were tabulated and analysed using descriptive statistical tool. Mean, standard deviation and comparison between the groups was done by student’s ‘t’ test. A p value less than 0.0001 was considered significant.Results: Mean duration of sedation of dexmedetomidine was 129.6±41.02 and for tramadol was 117.3 ± 47.75 (p=0.14), mean degree of sedation in both group was -1, mean duration of analgesia 139 min in Group D and 280 min in Group T (p<0.0001), rescue analgesia was required at 169th min in Group D and 288th min in Group T (p<0.0001), mean heart rate in Group D was 67.8±5.24 and 69.4±4.79 (p=0.12), mean Mean Arterial Pressure (MAP) in Group D was 78.0±8.97 and in Group T was 89.2±10.63 (p<0.00001), mean respiratory rate in Group D was 15.8±2.33 and in Group T was 15.9±2.09 (p=0.41), mean SPO2 in Group D was 99.5±0.56 and in Group T was 99.4±0.62 (p=0.14). There was no significant difference in degree and duration of sedation, duration of analgesia, vital parameters, and adverse effects in both groups but there was a statistical difference in the duration of analgesia and the need for rescue analgesia in Group D.Conclusion: Though there is no statistical difference in both groups, dexmedetomidine significantly reduced anxiety, agitation and produced calmness in postoperative patients which was not seen with tramadol

Analysis of cost of various topical and oral antifungal drugs for superficial fungal infections available in India

Background: In tropical countries like India, superficial fungal infections are quite common and certain infections like tinea is rampantly spreading in epidemic proportions and frequent relapses after treatment have increased the need for long term therapy significantly increasing the cost of treatment, so the treatment of fungal infection can raise economic burden on the patient. The aim of the study was to analyze the cost variation of topical antifungal drugs and oral antifungal drugs of various brands for superficial fungal infection available in India.Methods: Cost in Indian Rupees (INR) of antifungal agents manufactured by different pharmaceutical companies in India was collected from the Current index of medical specialities (CIMS) October to December 2019. Minimum cost, maximum cost, cost ratio, cost variation was calculated.Results: In oral dosage form, fluconazole, Itraconazole show the maximum cost variation. In topical single drug therapy luliconazole, terbinafine show maximum cost variation.Conclusions: There is wide cost variation among antifungal agents available in Indian Market. There is need of strict actions for cost policy regulation and sensitization of doctor for selection of appropriate brand drugs.