Evaluation of Medical Officers' Certificate Programme (MOCP) Course Competency Based Learning

Medical Officers' Certificate Programme (MOCP) is a 6 months training programme in Pediatrics/Medicine at Medical colleges wherein doctors work like postgraduate students, learn various OPD, IPD, (Out Patients and In Patient Department) procedures, attain hands on skills, perform day and night duties, attend postgraduate training programmes and specialty clinics. This is a course unique to Maharashtra. It has been designed to overcome shortage of Pediatrians & Physicians in the state. Public Health Dept deputed 28 Medical Officers of Primary Health Centers to various Medical Colleges. At the end of 6 months training course they were evaluated during 2012-2013.It was done by questionnaire used before and after training. It was observed that OPD increased by 24% and IPD by 54%. There was a decrease in the number of cases referred to tertiary centers by 24%, post MOCP training. Infant immunization increased by 35% after training. Number of children with severe acute malnutrition/moderate acute malnutrition treated increased by 22%, neonatal emergencies, resuscitation, sepsis, jaundice patients treated, increased by 36%. No of adults with diarrhoea and snake bite treated increased by 40% & 63% respectively. No. of ECGs taken and myocardial infarctions managed also has shown rising trend. Thus, there was tremendous benefit to the patients after MOCP training. Skill of doctors was found to have enhanced. It is therefore recommended that such novel trainings should be imparted in other states of India too

Enhancement of Physio-Mechanical Properties of Concrete Using Steel, PPF, SYF Fibers and their Feasibility for Road Construction

Plain concrete has two major deficiencies, Aghuy y low tensile strength and a low strain at fracture. The tensile strength of concrete is very low because plain concrete normally contains numerous micro cracks. It is the rapid propagation of these micro cracks under applied stress that is responsible for the low tensile strength of the material, eventually leading to brittle fracture of concrete. In past attempts have been made to impart improvements in tensile properties of concrete members by way of using conventional reinforced steel bars and also by applying restraining techniques. Although both methods provide tensile strength to concrete members, they how ever do not increase inherent tensile strength to concrete itself. It has been found that the addition of small closely spaced and uniformly dispersed fibers to concrete would act as crack arresters and would substantially improve its static and dynamic properties. This type of concrete is known as "Fiber Reinforced Concrete" (F.R.C.) This paper gives experimental investigation of steel, polypropylene and synthetic fiber in a glance. 24 cubes and 16 beams of M-40 grade concrete have been casted for different volumes of fiber based on literature survey. These specimens have been tested for compressive and flexural strength in laboratory based on the procedure given in codes. The results are analyzed and final conclusion is drawn. Based on conclusion, the fiber percentage is selected with considering technical and economical aspects which is 0.3% polypropylene fibers. Two slabs having dimensions 1m X 1mX 0.25m, one with 0.3% polypropylene fiber and another with normal concrete of M-40 grade have been cast. These slabs have been observed for the crack behavior after 28 days curing to come to final conclusion of the work done

COMPARISON OF THE EFFECTIVENESS OF VISUAL IMAGERY TECHNIQUE AND PROGRESSIVE RELAXATION TECHNIQUE ON ANXIETY AND DEPRESSION IN SUBJECTS WITH MODERATE CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Objectives: (1) To determine the effectiveness of visual imagery technique (VIT) on anxiety and depression in moderate chronic obstructive lung disease, (2) to determine the effectiveness of progressive relaxation technique (PRT) on anxiety and depression in moderate chronic obstructive lung disease (COPD), and (3) to compare the effectiveness of VIT and PRT on anxiety and depression in moderate COPD.Methods: Ethical clearance was obtained from the institutional ethical committee. A total of 45 stable moderate COPD patients were selected by simple random sampling, according to inclusion and exclusion criteria. 22 patients of Group A received VIT and 23 of Group B received PRT with a baseline treatment of conventional physiotherapy in both groups for 60 minutes twice a day for 5 days in the Pulmonology Department, Krishna Hospital, Karad.Result: Statistics was analyzed using paired t-test and unpaired t-test. In pre-intervention, there was no statistically significant difference seen for depression anxiety stress scale (DASS21) (p=D 0.0189, A 0.0002, S <0.0001) (t=D 2.440, A 4.053, S 5.105), hospital anxiety depression scale (HADS) (p=D 0.7677, A 0.5121) (t=D 0.2973, A 0.6610), and 6-min walk test (6MWT) (p=D 0.5948, RPE 0.0658) (t=D 0.5359, RPE 1.888). On comparing, the post-interventional values between the two groups using unpaired t-test proved that there was extremely statistically significant difference seen for DASS21 (p=D 0.0011, A <0.0001, S <0.0001) (t=D 3.504, A 9.220, S 13.508), HADS (p=D <0.0001, A <0.0001) (t=D <0.0001, A <0.0001), and 6MWT (p=distance 0.7041, RPE <0.0001) (t=distance 0.3824, RPE <0.0001).Conclusion: VIT along with conventional physiotherapy was significant both statistically and clinically compared to PRT on anxiety and depression in moderate COPD patients

A RANDOMIZED CASE–CONTROL PILOT STUDY ON THE NEUROCHEMICAL BASIS OF PAIN MODULATION IN PATIENTS WITH MIGRAINE, WHO PRACTICED INTEGRATED AMRITA MEDITATION TECHNIQUE

Objective: The objective of the study was to determine the changes in duration and intensity of headache and associated changes in the plasma levels of neurochemicals, serotonin, glutamate, vasoactive intestinal peptide (VIP), and nitric oxide (NO) in patients with migraine after 6 months of regular practice of integrated Amrita meditation (IAM). Methods: Sixteen patients aged 18–50 with migraine were randomly assigned to 2 groups, one with standard medical care and IAM, and the other only standard medical care. Data were collected before IAM, after 3 and 6 months of IAM practice Results: After 6 months, a significant decrease in the duration of headache from 2.4±0.54 to 1.4±0.54 (p=0.034) hours and intensity of pain from 3.6±0.54 to 2.6±0.89, (p=0.035) was seen in patients who practiced IAM. Plasma levels of serotonin within the IAM group increased (47.29±26.85 to 53.85±29.73ng/ml), where as there was decrease in glutamate (38.47±8.2 to 29.68±12.57μg/ml), VIP (28.01±13.64 to 22.23±7.79pg/ml) and NO levels (642.26±167.42 to 423.18±97.96μmol/L). A correlating trend was seen in comparison with control group after 6 months showing a statistically significant difference in plasma Serotonin (p value 0.007) and NO (p value-0.023) levels. Discussion: The results of our study have been discussed with other migraine and meditation-related studies. Conclusion: Regular practice of IAM reduces the intensity and duration of headache in migraine patients and is associated with alterations in the neurotransmitter levels

The interaction of Indian monsoon depressions with northwesterly mid-level dry intrusions

Monsoon depressions (MDs) bring substantial monsoon rainfall to northern and central India. These events usually form over the Bay of Bengal and travel across northern India toward Pakistan. Using European Centre for Medium-Range Weather Forecasting Interim Reanalysis, an MD tracking algorithm, and an objective identification method, we find that about 40% of MDs interact with northerly intrusions of dry desert air masses as the MDs traverse the subcontinent. MD interactions with dry intrusions are often preceded by positive potential vorticity anomalies on the subtropical jet and low level anticyclonic anomalies over the north Arabian Sea. Dry intrusions nearly halve the precipitation rate in the southwest quadrant of MDs, where MDs rain the most. However, dry intrusions increase the rainfall rate near the MD center. Similarly, ascent is reduced west of the MD center and enhanced at the MD center, especially in the upper troposphere. The reduced ascent west of MD centers is likely attributable to changes in vertical shear reducing differential cyclonic vorticity advection. Dry intrusions slightly reduce MDs’ propagation speed. For the mid-upper level vortex, this can be explained by anomalous westerlies reducing propagation by adiabatic advection. For the lower tropospheric vortex, it is likely that reduced diabatic generation of PV plays a role in slowing propagation, along with reduced adiabatic advection

Study on the Drying Characteristics of Green Gram, Cowpea and Soybean

The study reveals the drying characteristics of Green gram, Cowpea and Soybean when exposed to two different drying mechanisms namely convective (i.e., Tray Drying) and a innovative method (i.e., microwave drying). The objective of the study is to come out with a most appropriate drying technique which gives the product a better keeping quality. In this study the drying characteristics i.e the amount of moisture removed for every 10min is calculated at different temperatures for the respective samples. The sample was dried in tray dryer and microwave at two temperatures

Formation and Stability of Binary and Ternary Metal Complexes Containing Chelating Ligands and Their Biological Activity

Antioxidant activity of Ni(II) and Cd(II) binary and their mixed ligand complexes. Binary and mixed complexes were synthesised and were subjected to elemental analysis, conductivity studies, IR spectral studies, magnetic properties were analysed. Their biological activity in plants showed that the Ni(II) mixed ligand complexes with ethylenediamine and alanine showed more response than all other mixed ligand complexes of Ni(II) and Cd(II)

Effectiveness of VIA, Pap, and HPV DNA Testing in a Cervical Cancer Screening Program in a Peri-Urban Community in Andhra Pradesh, India

BACKGROUND: While many studies have compared the efficacy of Pap cytology, visual inspection with acetic acid (VIA) and human papillomavirus (HPV) DNA assays for the detection cervical intraepithelial neoplasia and cancer, few have evaluated the program effectiveness. METHODS AND FINDINGS: A population-based sample of 5603 women from Medchal Mandal in Andhra Pradesh, India were invited to participate in a study comparing Pap cytology, VIA, and HPV DNA screening for the detection of CIN3+. Participation in primary screening and all subsequent follow-up visits was rigorously tracked. A 20% random sample of all women screened, in addition to all women with a positive screening test result underwent colposcopy with directed biopsy for final diagnosis. Sensitivity, specificity, positive and negative predictive values were adjusted for verification bias. HPV testing had a higher sensitivity (100%) and specificity (90.6%) compared to Pap cytology (sensitivity  =  78.2%; specificity = 86.0%) and VIA (sensitivity = 31.6%; specificity = 87.5%). Since 58% of the sample refused involvement and another 28% refused colposcopy or biopsy, we estimated that potentially 87.6% of the total underlying cases of CIN3 and cancer may have been missed due to program failures. CONCLUSIONS: We conclude that despite our use of available resources, infrastructure, and guidelines for cervical cancer screening implementation in resource limited areas, community participation and non-compliance remain the major obstacles to successful reduction in cervical cancer mortality in this Indian population. HPV DNA testing was both more sensitive and specific than Pap cytology and VIA. The use of a less invasive and more user-friendly primary screening strategy (such as self-collected swabs for HPV DNA testing) may be required to achieve the coverage necessary for effective reduction in cervical cancer mortality

Frozen Section Evaluation in Head and Neck Oncosurgery: An Initial Experience in a Tertiary Cancer Center

Objective: Frozen section evaluation is routinely used by oncosurgeons across specialties for rapid assessment of the presence of tumor in any tissue and its most common use is in surgical margins. Today, the use of intraoperative frozen-section evaluation of surgical margins is an accepted and frequent practice in head and neck oncology. This study aims to determine the efficacy and accuracy of frozen sections in head and neck cancer patients and compare the results with the respective paraffin sections and also to analyze the reasons for any disparity between them. Material and Method: A retrospective study was conducted to evaluate efficacy and accuracy of frozen section in head and neck cancer of 265 patients, treated at a tertiary cancer centre hospital between January 2013 to December 2014. Results: Out of 265 cases, it was found that 12.6% of these sections showed true positivity, 6.3% false positivity, 2.9% false negativity and 78.2% true negativity. The study also shows a sensitivity of 82.05% and specificity of 96.46%. Conclusion: Our study shows that intraoperative frozen section reports are specific and highly sensitive. We recommend a minimum of 3-4 sections, optimum cryostat temperature, good section thickness and quality staining for a good concordance rate