To introduce and measure the effectiveness of case based learning in physiology

Background: Student/learner centered strategies are needed to promote active learning in the students. Medical Council of India (MCI) also encourages learner centric approaches. Objectives of the study were to develop case scenarios for teaching in Physiology and use them to teach 1st professional MBBS students and to evaluate the impact of this intervention on students’ learning.Methods: After the approval from Institutional Ethics Committee (IEC) the study was conducted on MBBS 1st professional students. The students were taught two topics using CBL strategy. Pre-post test score were taken for evaluation of students’ learning. Students’ feedback was taken to elicit their perceptions about the effectiveness of the strategy. Faculty feedback was also taken for feasibility and implementation of CBL.Results: Majority of the students were satisfied with the session. Majority felt it to be a good learning experience and many wanted to attend more such sessions. Difference in the pre-post test scores was statistically highly significant.Conclusions: CBL proved to be an interesting and effective active learning strategy. More of such sessions should be conducted to engage the students as felt by students and faculty both

Isolation and functional characterization of Lycopene β-cyclase (CYC-B) promoter from Solanum habrochaites

<p>Abstract</p> <p>Background</p> <p>Carotenoids are a group of C40 isoprenoid molecules that play diverse biological and ecological roles in plants. Tomato is an important vegetable in human diet and provides the vitamin A precursor <it>β</it>-carotene. Genes encoding enzymes involved in carotenoid biosynthetic pathway have been cloned. However, regulation of genes involved in carotenoid biosynthetic pathway and accumulation of specific carotenoid in chromoplasts are not well understood. One of the approaches to understand regulation of carotenoid metabolism is to characterize the promoters of genes encoding proteins involved in carotenoid metabolism. <it>Lycopene β-cyclase </it>is one of the crucial enzymes in carotenoid biosynthesis pathway in plants. Its activity is required for synthesis of both α-and β-carotenes that are further converted into other carotenoids such as lutein, zeaxanthin, etc. This study describes the isolation and characterization of chromoplast-specific <it>Lycopene β-cyclase </it>(<it>CYC-B</it>) promoter from a green fruited <it>S. habrochaites </it>genotype EC520061.</p> <p>Results</p> <p>A 908 bp region upstream to the initiation codon of the <it>Lycopene β-cyclase </it>gene was cloned and identified as full-length promoter. To identify promoter region necessary for regulating developmental expression of the <it>ShCYC-B </it>gene, the full-length promoter and its three different 5' truncated fragments were cloned upstream to the initiation codon of <it>GUS </it>reporter cDNA in binary vectors. These four plant transformation vectors were separately transformed in to <it>Agrobacterium</it>. <it>Agrobacterium</it>-mediated transient and stable expression systems were used to study the <it>GUS </it>expression driven by the full-length promoter and its 5' deletion fragments in tomato. The full-length promoter showed a basal level activity in leaves, and its expression was upregulated > 5-fold in flowers and fruits in transgenic tomato plants. Deletion of -908 to -577 bp 5' to ATG decreases the <it>ShCYC-B </it>promoter strength, while deletion of -908 to -437 bp 5' to ATG led to significant increase in the activity of GUS in the transgenic plants. Promoter deletion analysis led to the identification of a short promoter region (-436 bp to ATG) that exhibited a higher promoter strength but similar developmental expression pattern as compared with the full-length <it>ShCYC-B </it>promoter.</p> <p>Conclusion</p> <p>Functional characterization of the full-length <it>ShCYC-B </it>promoter and its deletion fragments in transient expression system <it>in fruto </it>as well as in stable transgenic tomato revealed that the promoter is developmentally regulated and its expression is upregulated in chromoplast-rich flowers and fruits. Our study identified a short promoter region with functional activity and developmental expression pattern similar to that of the full-length <it>ShCYC-B </it>promoter. This 436 bp promoter region can be used in promoter::reporter fusion molecular genetic screens to identify mutants impaired in <it>CYC-B </it>expression, and thus can be a valuable tool in understanding carotenoid metabolism in tomato. Moreover, this short promoter region of <it>ShCYC-B </it>may be useful in genetic engineering of carotenoid content and other agronomic traits in tomato fruits.</p

Broad ligament ectopic pregnancy: a dilemma to diagnose

Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis, but definitive diagnosis is made only during surgery. Authors are reporting a case of 30 years female G3P1L1A1 seven weeks pregnancy with previous lower segment cesarean section and previous history of right sided salpingectomy with no complaints. Ultrasound was advised to know the location of sac this time, in which, she was diagnosed as a case right sided unruptured live ovarian ectopic pregnancy. On examination, signs and symptoms of ectopic pregnancy were absent. On laparoscopy, she was diagnosed as a case of right sided live unruptured broad ligament ectopic pregnancy as her right ovary was absent because of previous surgery.  With advances in sonography and laparoscopic skills, more cases can be diagnosed in the first trimester and can be safely managed laparoscopically.

Comparison of metformin and insulin in the treatment of gestational diabetes: a retrospective study

Background: As various data are available on treatment of gestational diabetes mellitus (GDM), our aim is to compare the effect of treatment of metformin, insulin and diet control in GDM on maternal and neonatal outcomes.Methods: A retrospective study was conducted and it includes 50 women of GDM treated with Metformin, 50 women with insulin and 50 with only diet control without any drug.Results: The outcome was not much different in all groups studied. Maternal outcomes were similar in all three groups. The difference was: post prandial glucose values after 2 hour of oral glucose were slightly high in the insulin group than in the metformin group (p <0.003). Neonatal outcome was also not different in all groups. But the incidence of neonatal hypoglycemia was higher in the insulin group (p = 0.03).Conclusions: The study suggests that metformin is effective for GDM and maternal or neonatal outcomes were similar as compared with insulin

Overview of liver disorders during pregnancy at a tertiary care centre: Uttarakhand scenario

Background: Liver disorders in pregnancy encompass a spectrum of diseases encountered during antenatal and postnatal period resulting in abnormal liver function tests and hepatobiliary dysfunction or both. This study is aimed at determining the causes of liver disorders during pregnancy and associated maternal and fetal outcomes over a period of 3 years at a tertiary care centre of Dehradun.Methods: All case records of patients with liver disorders during pregnancy from May 2013 to May 2016 were retrieved from medical record department of SGRRIMHS, Dehradun and analyzed for various causes of liver disorders and associated maternal and fetal outcomes.Results: During the three-year study period, 146 pregnant patients were found to have liver disorders. The study found that viral hepatitis was the most common cause of liver disorders followed by Intrahepatic cholestasis of pregnancy IHCP. There were 6 mortalities among the study group out of which hepatitis E was the culprit for maternal mortality in two patients. The serum bilirubin levels were directly proportional to the maternal deaths.Conclusions: Liver disorders during pregnancy are rare but an important cause of maternal and fetal morbidity and mortality. Early recognition, timely referral and aggressive management may lead to better maternal and fetal outcome

Analysis of maternal deaths over a period of three years at a tertiary care centre of Uttarakhand, India

Background: Globally, about 800 women die every day of preventable causes related to pregnancy and childbirth; 20 per cent of these women are from India. The study is aimed at evaluating maternal deaths over a period of three years at a tertiary care centre of Dehradun, India.Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology at SGRRIMHS, Dehradun. The case record files of all maternal deaths from January 2015 to December 2017 was obtained from medical record section of the hospital. Maternal age, parity, educational status, antenatal registration, mode of delivery, admission death interval and causes of each maternal death was noted and analysed statistically.Results: There were 48 maternal deaths from January 2015 to December 2017.Maximum deaths were in the age group of 21-25 years. The maternal mortality ratio over a period of three years was 671 per one lac live births. Most of the maternal deaths were due to direct causes like hemorrhage , eclampsia followed by sepsis.Conclusions: Most of the maternal deaths are preventable. High risk cases should be identified at root level and early referral should be the moto. All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. To avoid maternal deaths, unwanted and too-early pregnancies should be avoided. All women, including adolescents, should have access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby

Bakri postpartum balloon: an obstetrician’s armamentarium in managing post-partum haemorrhage

Background: Post-partum haemorrhage (PPH), an obstetric emergency that can complicate vaginal or cesarean deliveries and associated with serious complications. Guidelines for the management of PPH involve a stepwise escalation of pharmacological and eventual surgical approaches. In women who do not respond to uterotonics or medical treatment, a variety of procedures, such as arterial embolization, surgical ligation of the uterine arteries or obstetric hysterectomy, may be used. The Bakri balloon is an intrauterine device indicated to reduce or control PPH temporarily when conservative treatment is warranted. Here, we are presenting case series of primary atonic PPH and which were managed by Bakri Balloon Tamponade (BBT).Methods: This case series included five women with PPH managed by Bakri balloon as a conservative therapeutic option.Results: All five women were in age group between 23 years to 34 years. The causes of PPH were uterine atony, retained placenta and central placenta previa. The Bakri balloon was successful in controlling hemorrhage in all women (five of five) who did not respond to medical uterotonic treatment.Conclusions: Bakri balloon is a simple, easy to use and effective method for conservative management of acute PPH. This device reduces bleeding, shortens the hospital stay and avoids the need for more aggressive procedures

UTILIZATION OF UNSERVICEABLE STRAWBERRIES FOR PRODUCTION OF ELLAGIC ACID AND ITS ENHANCEMENT BY ASPERGILLUS NIGER

Objective: Use of Aspergillus Niger (616) for the fabrication of ellagic acid from unserviceable strawberry as a substrate which is readily and chiefly available from Agro-industries and farm waste.Methods: The ellagic acid content was determined by HPLC method which shows a higher concentration of ellagic acid (143.085+1.669 ppm) after fermentation of 96 h at 35 °C. DPPH assay was carried out for antioxidant activity of ellagic acid.Results: Results designated that ellagic acid has higher antioxidant activity as compared with ascorbic acid.Conclusion: Existing study exposes that this agro waste and farm waste can be used at commercially for the production of ellagic acid which has enormous medicinal properties.Keywords: Ellagic acid, Raw strawberry, DPPH assay, Aspergillus Niger, Fermentation, and HPL

Assessment of the genetic diversity among oily spot (Xanthomonas axonopodis pv. punicae) pathogen of pomegranate by randomly amplified polymorphic DNA analysis

Pomegranate (Punica granatum L.) is an important fruit crop of India and other subtropical countries. Bacterial blight caused by Xanthomonas axonopodis pv. Punicae is becoming a major threat in Maharashtra as well as other states of India. It causes yield losses up to the extent of 80 – 90 %. This study aims to the collection of 7 strains (X. axonopodis) and utilized for assessment of genetic diversity by using RAPD markers. Whereas 7 strains of X. axonopodis were differentiated and distinguished into seven major region representing Malegaon, Nampur, Satana, Khakurdi, Ramnagar, Rahuri and Nashik region. However the genetic similarity within 7strains of X. axonopodis was ranged between 72.72-100 %. Similarly the genetic relationship of strains X. axonopodis was also established and showed 72.72 %, 72.72 %, 72.72 % 92.30%, 94.11% and 100 % similarity with region of Malegaon, Nampur, Satana, Khakurdi, Ramnagar, Rahuri and Nashik region. Average polymorphism in strains of X. axanopodis based on RAPD analysis was 84.095 %. The combine data analysis by using UPGMA method also revealed the two distinct groups representing seven strains of X. axonopodis and in first group M1 and second group R4 and subgroup RH6, N2, NS7, S3, K5, these genotypes were present respectively. Considering predominance and economic loss caused by X. axonopodis pv. punicae in pomegranate, it is an essential to undertake preliminary work on characterization of this pathogen at the molecular level

In vitro anti-inflammatory, anti-diabetic and antioxidant potential of Cissus quadrangularis along with its orexigenic activity in Drosophila melanogaster

Plants with diverse pharmacological activities are actively being explored for human health. Cissus quadrangularis (L) has been reported to possess numerous phytochemicals and is used to relieve various disorders. This article aims at providing evidence of the diverse pharmacological activities in terms of orexigenic, anti-inflammatory, anti-diabetic and antioxidant activities of C. quadrangularis for further application in clinical development. The results revealed that inhibition of hemolysis was within the range of 8-9-25.6% at concentrations of 12.5-200 µg/ml. Methanol extract of C. quadrangularis stems exhibited porcine pancreatic ?-amylase (PPA) inhibition (p?0.05) at concentrations of 0.25 and 0.30 mg/ml. The glucose adsorption capacity of the C. quadrangularis was observed to be inversely proportional to the molar concentration of glucose. The higher food intake by Drosophila in food medium with plant extract is presumably related to orexigenic property of C. quadrangularis. Protease activity of C. quadrangularis stem extract revealed total activity 975 U/ml and specific activity as 3768 U/mg. The absorbance of C. quadrangularis in reducing power assay were between 0.91and 1.85. Highest total antioxidant activity of 67.2 µg TE/g was observed and the hydroxyl radicals scavenging activity was observed in a dose dependent manner. The results provide supporting data that C. quadrangularis may contain active compounds useful in treating anti-inflammatory, anti-diabetic disorders